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General NPI Number Information
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NPI Number | 1902629538
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Entity Type | Organization
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Legal Business Name | NORCAL REGISTERED NURSING PRACTITIONER SERVICES, INC.
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Dates
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Enumeration Date | 11/04/2024
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Last Update Date | 11/04/2024
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Provider Practice Location Address
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Address Line | 1120 SILVERADO ST STE 203
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City | LA JOLLA
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State | CA
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Zip | 92037-4524
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Country | US
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Telephone | 916-545-2600
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Fax | 916-545-2601
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Provider Business Mailing Address
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Address Line | 1120 SILVERADO ST STE 203
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City | LA JOLLA
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State | CA
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Zip | 92037-4524
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Country | US
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Telephone | 916-545-2600
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Fax | 916-545-2601
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Authorized Official
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Title or Position | OWNER
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Name | MOLLY MCKEEN
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Credential |
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Telephone | 619-610-8472
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363LP0808X
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Taxonomy Name | Psychiatric/Mental Health Nurse Practitioner
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License Number |
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License Number State |
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