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NPI Code Detail

MEDICARE: MRS. NANCY SUGATAN BUENDIA

MEDICARE: MRS. NANCY SUGATAN BUENDIA
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
1224Z00000XOccupational Therapy Assistant755CA

General Provider Information

NPI Number : 1972434314
Entity Type Code : Individual
Provider Name (Legal Business Name) : MRS. NANCY SUGATAN BUENDIA
Provider Business Mailing Address
First Line : 4100 NORMAL ST
Second Line :
City : SAN DIEGO
State : CA
Zip : 92103-2653
Country : US
Telephone Number : 619-725-5501
Fax Number :
Provider Business Practice Location Address
First Line : 4100 NORMAL ST
Second Line :
City : SAN DIEGO
State : CA
Zip : 92103-2653
Country : US
Telephone Number : 619-725-5501
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 05/26/2026
Last Update Date : 05/26/2026

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