Healthcare Provider Details

I. General information

NPI: 1477236313
Provider Name (Legal Business Name): JESSICA APPLEGET MSN, RN, CNS
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/08/2023
Last Update Date: 08/08/2023
Certification Date: 08/08/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3030 CHILDRENS WAY
SAN DIEGO CA
92123-4232
US

IV. Provider business mailing address

1147 HANFORD CT
CHULA VISTA CA
91913-1444
US

V. Phone/Fax

Practice location:
  • Phone: 858-576-1700
  • Fax:
Mailing address:
  • Phone: 831-229-5551
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code364SP0200X
TaxonomyPediatric Clinical Nurse Specialist
License Number4964
License Number StateCA
# 2
Primary TaxonomyN
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License Number849736
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: