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General NPI Number Information
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NPI Number | 1780757823
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Entity Type | Individual
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Provider Name | CAROLE JOY RICHARDS CPNP
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Gender | Female
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Dates
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Enumeration Date | 11/16/2006
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Last Update Date | 07/08/2007
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Provider Practice Location Address
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Address Line | 8010 FROST ST SUITE 414
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City | SAN DIEGO
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State | CA
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Zip | 92123-2778
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Country | US
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Telephone | 858-966-7711
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Fax | 858-966-7712
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Provider Business Mailing Address
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Address Line | 1441 E 17TH ST
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City | NATIONAL CITY
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State | CA
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Zip | 91950-5018
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Country | US
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Telephone | 619-477-6162
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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 | 363LP0200X
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Taxonomy Name | Pediatric Nurse Practitioner
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License Number | 10775
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License Number State | CA
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