Healthcare Provider Details

I. General information

NPI: 1881509883
Provider Name (Legal Business Name): JOAN VALERIE C OBEDOZA
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/17/2026
Last Update Date: 08/17/2026
Certification Date: 08/16/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

451 RIVERVIEW PKWY
SANTEE CA
92071-5829
US

IV. Provider business mailing address

1339 DAWSON DR
CHULA VISTA CA
91911-7026
US

V. Phone/Fax

Practice location:
  • Phone: 619-409-5000
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License Number95244425
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: