MARISA DEPTALA (NPI# 1083166615) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1083166615 |
| Entity Type | Individual |
| Full Name | MARISA DEPTALA |
| Credential | FNP |
| Practice Address |
450 4th Ave Ste 408 Chula Vista CA 91910-4430 |
| Mailing Address |
450 Fourth Ave Ste 408 Chula Vista CA 91910-4430 |
| Practice Telephone | 6196911990 |
| Enumeration Date | 2016-10-31 |
| Last Update Date | 2018-04-13 |
| Gender Code | F |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 363LF0000X |
Nurse Practitioner Specialization: Family |
95005347 | CA | Physician Assistants & Advanced Practice Nursing Providers |
| Address | Telephone Number | Fax Number |
|---|---|---|
| 8695 Spectrum Center Blvd, San Diego, CA 921231489 | 8584995259 |
| Street Address |
450 4TH AVE STE 408 |
| City | CHULA VISTA |
| State | CA |
| Zip Code | 91910-4430 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1477194264 | Joshua Maurice Hayden | Dental Hygienist | 678 Thrid Ave, Chula Vista, CA 91910 | 2019-10-02 |
| 1255980504 | Samantha Bernaldo | Dental Hygienist | 668 Third Ave, Chula Vista, CA 91910 | 2019-09-10 |
| 1073179529 | Roshni Kakaiya | Student in an Organized Health Care Education/Training Program | 435 H Street, Cv112, Chula Vista, CA 91910 | 2019-05-09 |
| 1598232506 | Naria Le Mire | Dietitian, Registered | 288 Broadway #141a, Chula Vista, CA 91910 | 2018-10-28 |
| 1730676727 | Pei Chi Chain | Optometrist | 324 F Street., Chula Vista, CA 91910 | 2018-04-16 |
| 1104332741 | Teodoro David Pena | Dentist | 510 Broadway Ste 4-5, Chula Vista, CA 91910 | 2017-12-19 |
| 1538684865 | Camille Cooke | Counselor | 430 F. Street, Chula Vista, CA 91910 | 2017-08-08 |
| 1184146094 | Alexandra Lynn Scovill | Optometrist | Castillejos Eye Institute Medical Group, 342 F Street, Chula Vista, CA 91910 | 2017-07-12 |
| 1396270583 | Tam Trieu | Pharmacist | 555 Broaway Suite 1054, Chula Vista, CA 91910 | 2017-04-25 |
| 1548792815 | Sabrina Owens | Family Medicine | 499 H Street Cv112, Chula Vista, CA 91910 | 2017-03-28 |
| Find all providers in zip 91910 | ||||
| Taxonomy Code | 363LF0000X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Nurse Practitioner |
| Specialization | Family |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1316585649 | Beverly Anne Ramos | Nurse Practitioner | 1151 Santa Delphina Ave, Chula Vista, CA 91913-1713 | 2019-12-17 |
| 1982240420 | Carlynne Rivera Calleros | Nurse Practitioner | 765 Medical Center Ct Ste 218, Chula Vista, CA 91911-6600 | 2019-11-19 |
| 1164994240 | Aldrin Joe Juaneza Jaranilla | Nurse Practitioner | 892 Genevieve Ave, Chula Vista, CA 91913-3134 | 2018-12-29 |
| 1134696289 | Kathleen Mitchell | Nurse Practitioner | 2287 Calle Catarina, Chula Vista, CA 91914-4455 | 2018-10-26 |
| 1386120723 | Nezer B Belen | Nurse Practitioner | 1722 May Ave, Chula Vista, CA 91913-4309 | 2018-07-18 |
| 1285122721 | Romeo Andrew Virrey | Nurse Practitioner | 1840 Crossroads St, Chula Vista, CA 91915-2429 | 2018-04-30 |
| 1861980393 | Eileen Caoile Virrey | Nurse Practitioner | 1840 Crossroads Street, Chula Vista, CA 91915-2429 | 2018-04-30 |
| 1861989790 | Michael Salomon Radi | Nurse Practitioner | 1444 Carpinteria St, Chula Vista, CA 91913-2521 | 2018-04-17 |
| 1427565001 | Dianne Munoz | Nurse Practitioner | 855 Third Ave #3340, Chula Vista, CA 91911-1911 | 2018-01-04 |
| 1093253593 | Dao Nhiatou Vang | Nurse Practitioner | 608 Crescent Dr, Chula Vista, CA 91911-6855 | 2017-02-03 |
| Find all providers in CHULA VISTA | ||||
| City | CHULA VISTA |
| Zip Code | 91910 |
Please comment or provide details below to improve the information on MARISA DEPTALA.
| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.