Healthcare Provider Details

I. General information

NPI: 1053290106
Provider Name (Legal Business Name): LAURA MARIE CHECHEL MSN, RN, CNS
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 09/01/2025
Last Update Date: 09/01/2025
Certification Date: 08/31/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6655 ALVARADO RD
SAN DIEGO CA
92120-5208
US

IV. Provider business mailing address

5958 TROJAN AVE
SAN DIEGO CA
92115-5406
US

V. Phone/Fax

Practice location:
  • Phone: 619-543-6900
  • Fax:
Mailing address:
  • Phone: 401-524-8184
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code364S00000X
TaxonomyClinical Nurse Specialist
License Number4674
License Number StateCA
# 2
Primary TaxonomyN
Taxonomy Code163WC0200X
TaxonomyCritical Care Medicine Registered Nurse
License Number736027
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: