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NPI Code Detail

MEDICARE: DR. JACQUELINE D. RYCHNOVSKY PHD, RN, CPNP

MEDICARE: DR. JACQUELINE D. RYCHNOVSKY PHD, RN, CPNP
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
1363LP0200XPediatric Nurse Practitioner12380CA

General Provider Information

NPI Number : 1255300562
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. JACQUELINE D. RYCHNOVSKY PHD, RN, CPNP
Provider Business Mailing Address
First Line : 1848 LAGRANGE ROAD
Second Line :
City : CHULA VISTA
State : CA
Zip : 91913-1680
Country : US
Telephone Number : 619-889-8545
Fax Number : 619-934-4760
Provider Business Practice Location Address
First Line : 34800 BOB WILSON DR
Second Line : NAVAL MEDICAL CENTER
City : SAN DIEGO
State : CA
Zip : 92134-1098
Country : US
Telephone Number : 619-532-8234
Fax Number : 619-532-8137
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 03/17/2006
Last Update Date : 07/08/2007

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