Healthcare Provider Details

I. General information

NPI: 1033772793
Provider Name (Legal Business Name): WOCN SOLUTIONS PC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/18/2019
Last Update Date: 08/31/2022
Certification Date: 08/31/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

9149 W BLACK EAGLE DR
BOISE ID
83709-1572
US

IV. Provider business mailing address

1166 SAGEWOOD DR
OCEANSIDE CA
92056-6464
US

V. Phone/Fax

Practice location:
  • Phone: 562-665-6554
  • Fax:
Mailing address:
  • Phone: 562-665-6654
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code163WW0000X
TaxonomyWound Care Registered Nurse
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code261QM1300X
TaxonomyMulti-Specialty Clinic/Center
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License Number
License Number State

VIII. Authorized Official

Name: SEAN LEONARD
Title or Position: CEO
Credential: NP
Phone: 562-665-6654