Healthcare Provider Details

I. General information

NPI: 1073641437
Provider Name (Legal Business Name): CECILLE LAHIP SARMIENTO R.N.
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 02/28/2007
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3851 ROSECRANS ST.
SAN DIEGO CA
92110
US

IV. Provider business mailing address

4106 ARROYO WAY
NATIONAL CITY CA
91950-8246
US

V. Phone/Fax

Practice location:
  • Phone: 619-692-8865
  • Fax:
Mailing address:
  • Phone: 619-292-2670
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163WC1500X
TaxonomyCommunity Health Registered Nurse
License Number566208
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: