Healthcare Provider Details

I. General information

NPI: 1376459479
Provider Name (Legal Business Name): MS. ANNA THERESE PASCUAL BUGARIN
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/20/2026
Last Update Date: 08/20/2026
Certification Date: 08/20/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

655 PARK CENTER DR
SANTEE CA
92071-6957
US

IV. Provider business mailing address

4222 43RD ST APT 4
SAN DIEGO CA
92105-1280
US

V. Phone/Fax

Practice location:
  • Phone: 619-596-5500
  • Fax: 619-596-5501
Mailing address:
  • Phone: 619-596-5500
  • Fax: 619-596-5501

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code164X00000X
TaxonomyLicensed Vocational Nurse
License Number756474
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: