1457530180 NPI number — MONSITA JOSEFA FALEY FNP

Table of content: MONSITA JOSEFA FALEY FNP (NPI 1457530180)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1457530180 NPI number — MONSITA JOSEFA FALEY FNP

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
FALEY
Provider First Name:
MONSITA
Provider Middle Name:
JOSEFA
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
FNP
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
BROWN
Provider Other First Name:
MONSITA
Provider Other Middle Name:
JOSEFA
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:
5

NPI Number Information

NPI Number:
1457530180
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
12/04/2019
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
550 BURTON CT.
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
CARLSBAD
Provider Business Mailing Address State Name:
CA
Provider Business Mailing Address Postal Code:
92011
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
530-784-0186
Provider Business Mailing Address Fax Number:

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
SCRIPPS CLINIC MEDICAL GROUP
Provider Second Line Business Practice Location Address:
9898 GENESEE AVE
Provider Business Practice Location Address City Name:
LA JOLLA
Provider Business Practice Location Address State Name:
CA
Provider Business Practice Location Address Postal Code:
92037
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
858-824-5400
Provider Business Practice Location Address Fax Number:
858-964-3126
Provider Enumeration Date:
10/30/2007

Additional Information

			
		

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 363LF0000X , with the licence number:  16545 , registered in the state of CA ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)