Healthcare Provider Details

I. General information

NPI: 1396769535
Provider Name (Legal Business Name): ELIZABETH PINNER M.S.N.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/27/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8810 RIO SAN DIEGO DR SUITE 2200
SAN DIEGO CA
92108-1622
US

IV. Provider business mailing address

12758 SUNDANCE AVE
SAN DIEGO CA
92129-2216
US

V. Phone/Fax

Practice location:
  • Phone: 619-400-5162
  • Fax: 619-400-4252
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code364SP0809X
TaxonomyAdult Psychiatric/Mental Health Clinical Nurse Specialist
License NumberCA387395
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: