Healthcare Provider Details

I. General information

NPI: 1104770510
Provider Name (Legal Business Name): DAVINA LIMON
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 02/23/2026
Last Update Date: 02/23/2026
Certification Date: 02/23/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

9820 CARROLL CANYON RD # 3-203
SAN DIEGO CA
92131-1143
US

IV. Provider business mailing address

9820 CARROLL CANYON RD # 3-203
SAN DIEGO CA
92131-1143
US

V. Phone/Fax

Practice location:
  • Phone: 619-808-9199
  • Fax:
Mailing address:
  • Phone: 619-808-9199
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163WH0200X
TaxonomyHome Health Registered Nurse
License Number95348919
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: