Healthcare Provider Details

I. General information

NPI: 1437062122
Provider Name (Legal Business Name): POPULA HEALTH NURSING, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/24/2026
Last Update Date: 09/24/2026
Certification Date: 09/24/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1150 E ST UNIT 2505
SAN DIEGO CA
92101-8723
US

IV. Provider business mailing address

1150 E ST UNIT 2505
SAN DIEGO CA
92101-8723
US

V. Phone/Fax

Practice location:
  • Phone: 443-529-2027
  • Fax:
Mailing address:
  • Phone: 443-529-2027
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code163WC0400X
TaxonomyCase Management Registered Nurse
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code163WC1500X
TaxonomyCommunity Health Registered Nurse
License Number
License Number State

VIII. Authorized Official

Name: TIMIKA GOODSON
Title or Position: CEO
Credential: RN, APRN
Phone: 443-529-2027