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General NPI Number Information
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NPI Number | 1992611792
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Entity Type | Individual
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Provider Name | DELILA RAE WADE RN
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Gender | Female
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Dates
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Enumeration Date | 08/21/2026
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Last Update Date | 08/21/2026
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Provider Practice Location Address
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Address Line | 3880 MURPHY CANYON RD STE 110
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City | SAN DIEGO
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State | CA
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Zip | 92123-4411
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Country | US
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Telephone | 619-577-4074
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Fax |
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Provider Business Mailing Address
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Address Line | 10031 W MONTECITO AVE
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City | PHOENIX
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State | AZ
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Zip | 85037-5614
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Country | US
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Telephone | 623-256-9943
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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 | 163WS0200X
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Taxonomy Name | School Registered Nurse
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License Number | 335809
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License Number State | AZ
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