Healthcare Provider Details

I. General information

NPI: 1811969116
Provider Name (Legal Business Name): SHARI F JONES CRNA
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 02/02/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

34800 BOB WILSON DR SUITE 409
SAN DIEGO CA
92134-1098
US

IV. Provider business mailing address

3424 PARK WEST LN
SAN DIEGO CA
92117-1052
US

V. Phone/Fax

Practice location:
  • Phone: 619-532-8943
  • Fax: 619-532-8945
Mailing address:
  • Phone: 858-272-8262
  • Fax: 858-273-0408

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code367500000X
TaxonomyCertified Registered Nurse Anesthetist
License Number070547
License Number StateIL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: