MEDICARE: SANDRA JOY FOLEY PNP

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	363LP0200X	Pediatric Nurse Practitioner	NPF7030	CA

General Provider Information

NPI Number	:	1235172289
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	SANDRA JOY FOLEY PNP

Provider Business Mailing Address
First Line	:	10428 GRETLER PL
Second Line	:
City	:	LA MESA
State	:	CA
Zip	:	91941-6937
Country	:	US
Telephone Number	:	619-440-7053
Fax Number	:

Provider Business Practice Location Address
First Line	:	6475 ALVARADO RD
Second Line	:	SUITE 120
City	:	SAN DIEGO
State	:	CA
Zip	:	92120-5003
Country	:	US
Telephone Number	:	619-583-6133
Fax Number	:	619-583-0321

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	06/14/2006
Last Update Date	:	02/07/2012

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