Healthcare Provider Details

I. General information

NPI: 1376366229
Provider Name (Legal Business Name): SERENITY CURLEY
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 11/07/2024
Last Update Date: 03/13/2025
Certification Date: 03/13/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

10717 CAMINO RUIZ STE 207
SAN DIEGO CA
92126-2364
US

IV. Provider business mailing address

10717 CAMINO RUIZ STE 207
SAN DIEGO CA
92126-2364
US

V. Phone/Fax

Practice location:
  • Phone: 858-695-2211
  • Fax: 858-695-3521
Mailing address:
  • Phone: 858-695-2211
  • Fax: 858-695-3521

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363AM0700X
TaxonomyMedical Physician Assistant
License NumberH8C9E2M2
License Number StateCA
# 2
Primary TaxonomyN
Taxonomy Code172V00000X
TaxonomyCommunity Health Worker
License Number
License Number StateNULL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: