Healthcare Provider Details

I. General information

NPI: 1801267778
Provider Name (Legal Business Name): JAMIE FELICE RN, LC
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 10/16/2015
Last Update Date: 10/16/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2135 FRANKFORT ST
SAN DIEGO CA
92110-3412
US

IV. Provider business mailing address

2135 FRANKFORT ST
SAN DIEGO CA
92110-3412
US

V. Phone/Fax

Practice location:
  • Phone: 619-701-9441
  • Fax:
Mailing address:
  • Phone: 619-701-9441
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code163WL0100X
TaxonomyLactation Consultant (Registered Nurse)
License Number822315
License Number StateCA
# 2
Primary TaxonomyY
Taxonomy Code163WM0102X
TaxonomyMaternal Newborn Registered Nurse
License Number822315
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: