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General NPI Number Information
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NPI Number | 1073947362
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Entity Type | Individual
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Provider Name | JOELLE NICOLE NEGLEY PA
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Gender | Female
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Dates
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Enumeration Date | 08/22/2013
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Last Update Date | 09/18/2015
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Provider Practice Location Address
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Address Line | 8851 CENTER DR SUITE 505
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City | LA MESA
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State | CA
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Zip | 91942-3017
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Country | US
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Telephone | 619-461-3880
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Fax | 619-461-3895
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Provider Business Mailing Address
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Address Line | 9610 GRANITE RIDGE DR SUITE B
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City | SAN DIEGO
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State | CA
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Zip | 92123-2684
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Country | US
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Telephone | 858-810-8000
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Fax | 858-268-1911
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363A00000X
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Taxonomy Name | Physician Assistant
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License Number | 52553
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License Number State | CA
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