Healthcare Provider Details

I. General information

NPI: 1164758751
Provider Name (Legal Business Name): ANA MARIA PRESTON NP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: ANA MARIA DELGADILLO VILLALOBOSS MD (MEXICO)

II. Dates (important events)

Enumeration Date: 11/02/2009
Last Update Date: 12/13/2021
Certification Date: 12/13/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1000 VALE TERRACE DR
VISTA CA
92084-5218
US

IV. Provider business mailing address

1000 VALE TERRACE DR
VISTA CA
92084-5218
US

V. Phone/Fax

Practice location:
  • Phone: 760-631-5000
  • Fax: 760-414-3892
Mailing address:
  • Phone: 760-631-5000
  • Fax: 760-414-3892

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License NumberRN756242
License Number StateCA
# 2
Primary TaxonomyY
Taxonomy Code363LW0102X
TaxonomyWomen's Health Nurse Practitioner
License Number95007073
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: