Healthcare Provider Details

I. General information

NPI: 1669071627
Provider Name (Legal Business Name): FELICIA ELIZABETH NASSIF RN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/21/2020
Last Update Date: 11/27/2023
Certification Date: 10/21/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6160 MISSION GORGE RD
SAN DIEGO CA
92120-3410
US

IV. Provider business mailing address

12911 TEXANA ST
SAN DIEGO CA
92129-3621
US

V. Phone/Fax

Practice location:
  • Phone: 619-528-4000
  • Fax:
Mailing address:
  • Phone: 805-701-6468
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163WC1500X
TaxonomyCommunity Health Registered Nurse
License Number755271
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: