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General NPI Number Information
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NPI Number | 1588351688
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Entity Type | Individual
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Provider Name | JACQUELINE CARLY COHN WHNP, RN
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Gender | Female
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Dates
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Enumeration Date | 04/19/2023
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Last Update Date | 04/19/2023
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Provider Practice Location Address
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Address Line | 11425 EL CAMINO REAL
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City | SAN DIEGO
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State | CA
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Zip | 92130-2045
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Country | US
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Telephone | 858-365-9605
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Fax | 619-848-7480
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Provider Business Mailing Address
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Address Line | 13347 ORANGE BLOSSOM WAY
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City | SAN DIEGO
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State | CA
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Zip | 92130-2716
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Country | US
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Telephone | 847-306-0411
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Fax |
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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 | 363LW0102X
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Taxonomy Name | Women's Health Nurse Practitioner
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License Number | 95004126
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License Number State | CA
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