Healthcare Provider Details

I. General information

NPI: 1568942530
Provider Name (Legal Business Name): VALERIE SUE POUNDS RCP RRT
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/18/2018
Last Update Date: 08/18/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

9455 CLAIREMONT MESA BLVD
SAN DIEGO CA
92123-1297
US

IV. Provider business mailing address

PO BOX 57
ALPINE CA
91903-0057
US

V. Phone/Fax

Practice location:
  • Phone: 858-266-4200
  • Fax:
Mailing address:
  • Phone: 619-889-9502
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2279C0205X
TaxonomyCritical Care Registered Respiratory Therapist
License Number20395
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: