Healthcare Provider Details

I. General information

NPI: 1285608331
Provider Name (Legal Business Name): NANCY V. CANTY N.P.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 02/15/2006
Last Update Date: 09/13/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

9339 GENESEE AVE SUITE 220
SAN DIEGO CA
92121-2119
US

IV. Provider business mailing address

9339 GENESEE AVE SUITE 220
SAN DIEGO CA
92121-2119
US

V. Phone/Fax

Practice location:
  • Phone: 858-455-7520
  • Fax: 858-554-1312
Mailing address:
  • Phone: 858-455-7520
  • Fax: 858-554-1312

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License NumberRN538827
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: