Healthcare Provider Details

I. General information

NPI: 1093023590
Provider Name (Legal Business Name): PAULO JOVER
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

Provider Other Name: PAUL JOVER

II. Dates (important events)

Enumeration Date: 09/17/2010
Last Update Date: 09/18/2025
Certification Date: 09/18/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3853 ROSECRANS ST
SAN DIEGO CA
92110-3115
US

IV. Provider business mailing address

17903 WESTLAWN ST
HESPERIA CA
92345-6918
US

V. Phone/Fax

Practice location:
  • Phone: 619-692-8232
  • Fax: 619-542-4060
Mailing address:
  • Phone: 760-887-7282
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163WP0809X
TaxonomyAdult Psychiatric/Mental Health Registered Nurse
License Number95140029
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: