Healthcare Provider Details

I. General information

NPI: 1568336204
Provider Name (Legal Business Name): JYL DELAROSA APRN
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 10/04/2025
Last Update Date: 06/12/2026
Certification Date: 06/12/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

16476 BERNARDO CENTER DR STE 200
SAN DIEGO CA
92128-2579
US

IV. Provider business mailing address

PO BOX 27996
SAN DIEGO CA
92198-1996
US

V. Phone/Fax

Practice location:
  • Phone: 858-231-0876
  • Fax:
Mailing address:
  • Phone: 808-780-2520
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License Number95034165
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: