Healthcare Provider Details

I. General information

NPI: 1003276700
Provider Name (Legal Business Name): CLAUDIO NUNEZ
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 02/24/2016
Last Update Date: 04/30/2026
Certification Date: 04/30/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

200 MICHIGAN AVE
VISTA CA
92084-5424
US

IV. Provider business mailing address

200 MICHIGAN AVE
VISTA CA
92084-5424
US

V. Phone/Fax

Practice location:
  • Phone: 760-509-3367
  • Fax:
Mailing address:
  • Phone: 760-509-3367
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code106H00000X
TaxonomyMarriage & Family Therapist
License Number125089
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: