Healthcare Provider Details

I. General information

NPI: 1790694156
Provider Name (Legal Business Name): SONIA GUADALUPE MUNOZ
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 09/02/2026
Last Update Date: 09/02/2026
Certification Date: 09/02/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

311 N SANTA FE AVE APT 310
VISTA CA
92084-5461
US

IV. Provider business mailing address

311 N SANTA FE AVE APT 310
VISTA CA
92084-5461
US

V. Phone/Fax

Practice location:
  • Phone: 760-978-8465
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code164X00000X
TaxonomyLicensed Vocational Nurse
License Number692334
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: