Healthcare Provider Details

I. General information

NPI: 1699926063
Provider Name (Legal Business Name): JOY LYNNE BRYCHTA RN, NP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: JOY LYNNE WILSON RN, NP

II. Dates (important events)

Enumeration Date: 10/03/2008
Last Update Date: 02/03/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

11230 SORRENTO VALLEY RD SUITE 120
SAN DIEGO CA
92121-1332
US

IV. Provider business mailing address

11230 SORRENTO VALLEY RD SUITE 120
SAN DIEGO CA
92121-1332
US

V. Phone/Fax

Practice location:
  • Phone: 858-546-7600
  • Fax: 858-408-4281
Mailing address:
  • Phone: 858-546-7600
  • Fax: 858-408-4281

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LW0102X
TaxonomyWomen's Health Nurse Practitioner
License Number668889
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: