Healthcare Provider Details

I. General information

NPI: 1932945318
Provider Name (Legal Business Name): EMILY VELIZ
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/03/2024
Last Update Date: 07/03/2024
Certification Date: 07/03/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3900 LOMALAND DR
SAN DIEGO CA
92106-2810
US

IV. Provider business mailing address

4625 SAUK AVE
SAN DIEGO CA
92117-2936
US

V. Phone/Fax

Practice location:
  • Phone: 619-849-2200
  • Fax:
Mailing address:
  • Phone: 858-775-2918
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code2255A2300X
TaxonomyAthletic Trainer
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code227800000X
TaxonomyCertified Respiratory Therapist
License Number
License Number State
# 3
Primary TaxonomyY
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: