MEDICARE: MRS. MELBA N ANCHETA RN

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	163W00000X	Registered Nurse	511000	CA

General Provider Information

NPI Number	:	1518153832
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MRS. MELBA N ANCHETA RN

Provider Business Mailing Address
First Line	:	11873 AVENIDA MARCELLA
Second Line	:
City	:	EL CAJON
State	:	CA
Zip	:	92019-4050
Country	:	US
Telephone Number	:	619-670-4826
Fax Number	:

Provider Business Practice Location Address
First Line	:	11873 AVENIDA MARCELLA
Second Line	:
City	:	EL CAJON
State	:	CA
Zip	:	92019-4050
Country	:	US
Telephone Number	:	619-670-4826
Fax Number	:

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

Provider Enumeration Date	:	09/20/2007
Last Update Date	:	09/20/2007

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