MRS. DAISIANETTE HODGE (NPI# 1164953576) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
Nation Provider ID (NPI) | 1164953576 |
Entity Type | Individual |
Full Name | MRS. DAISIANETTE HODGE |
Other Name | DAISY HODGE |
Credential | RN |
Practice Address |
1250 Morena Blvd San Diego CA 92110-3815 |
Mailing Address |
8510 Larkdale Ave San Diego CA 92123-2050 |
Practice Telephone | 6196928750 |
Practice Fax Number | 6196928779 |
Mailing Telephone | 6012125022 |
Enumeration Date | 2017-03-27 |
Last Update Date | 2018-09-17 |
Gender Code | F |
Is Sole Proprietor | N |
Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
---|---|---|---|---|---|
Y | 163WP0809X |
Registered Nurse Specialization: Psych/Mental Health, Adult |
95169891 | CA | Nursing Service Providers |
N | 164X00000X | Licensed Vocational Nurse | 686560 | CA | Nursing Service Providers |
Address | Telephone Number | Fax Number |
---|---|---|
600 B St # 5, 1570, San Diego, CA 921014501 | 6196150439 |
Street Address |
1250 MORENA BLVD |
City | SAN DIEGO |
State | CA |
Zip Code | 92110-3815 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1326138090 | Emily N Wang | Counselor | 1250 Morena Blvd, San Diego, CA 92110-3815 | 2006-10-13 |
1235748856 | Linda Kay Schaefer | Student in an Organized Health Care Education/Training Program | 1250 Morena Blvd, San Diego, CA 92110-3815 | 2020-07-29 |
1336758085 | Daniel Kruse | Student in an Organized Health Care Education/Training Program | 1250 Morena Blvd, San Diego, CA 92110-3815 | 2020-07-29 |
1073172862 | Genevieve Maurine Ford | Student in an Organized Health Care Education/Training Program | 1250 Morena Blvd, San Diego, CA 92110-3815 | 2019-06-06 |
1215404850 | Michelle Willcuts | Counselor | 1250 Morena Blvd, San Diego, CA 92110-3815 | 2018-11-01 |
1851877708 | Christine Marie Cate | Social Worker | 1250 Morena Blvd, San Diego, CA 92110-3815 | 2018-07-13 |
1225531148 | Briana Schuler | Case Manager/Care Coordinator | 1250 Morena Blvd, San Diego, CA 92110-3815 | 2018-03-16 |
1700398385 | Michael John Griffin | Case Manager/Care Coordinator | 1250 Morena Blvd, San Diego, CA 92110-3815 | 2017-11-03 |
1831625086 | Lisa Boinnard | Counselor | 1250 Morena Blvd, San Diego, CA 92110 | 2017-05-10 |
1316472046 | Madaline Lomibao | Student in an Organized Health Care Education/Training Program | 1250 Morena Blvd, San Diego, CA 92110-3815 | 2017-05-01 |
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NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1669021713 | Ruben Daniel Gutierrez | Marriage & Family Therapist | 4141 Pacific Coast Hwy, San Diego, CA 92110 | 2019-09-10 |
1548724081 | Denise Ellen Thompson | Counselor | 3255 Wings Street, San Diego, CA 92110 | 2019-01-29 |
1801378716 | Michelle Lisa Jean Crawford | Student in an Organized Health Care Education/Training Program | 3767 Central Avenue, San Diego, CA 92110 | 2018-09-06 |
1427539048 | Allison Turrell | Case Manager/Care Coordinator | 4930 Naples Street, San Diego, CA 92110 | 2018-08-22 |
1750872768 | Matthew Langworthy | Physical Therapist | 3405 Kenyon St Ste 212, San Diego, CA 92110 | 2018-05-24 |
1245748342 | The One Health Boutique, LLC | Chiropractor | 5350 Riley St, San Diego, CA 92110 | 2018-01-11 |
1437670155 | Monique A Fernandez | Counselor | 3132 Jefferson Street, San Diego, CA 92110 | 2017-07-03 |
1538510391 | Mayu Winters | Registered Nurse | 853 Rosecrans St, San Diego, CA 92110 | 2016-06-23 |
1376998864 | Briniti Ichull | Specialist | 3941 Kurtz St, San Diego, CA 92110 | 2016-05-03 |
1912352576 | Healthcare Services, Inc. | Substance Abuse Rehabilitation Facility | 3880 Rosecrans Street, San Diego, CA 92110 | 2016-05-02 |
Find all providers in zip 92110 |
Taxonomy Code | 163WP0809X |
Grouping | Nursing Service Providers |
Classification | Registered Nurse |
Specialization | Psych/Mental Health, Adult |
Definition to come... |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1689204265 | Juvelyn Isip Ingal | Registered Nurse | 3853 Rosecrans St # Ca92110, San Diego, CA 92110-3115 | 2020-01-22 |
1043859531 | Klair Grace | Registered Nurse | 6460 Convoy Ct Spc 115, San Diego, CA 92117-2314 | 2019-12-31 |
1225509656 | Erwin Orio Fong | Registered Nurse | 3853 Rosecran St, San Diego, CA 92110-3115 | 2018-12-11 |
1780139220 | Sarah Sangalang Villanueva | Registered Nurse | 1625 Chalcedony St, 205, San Diego, CA 92109-3169 | 2016-08-24 |
1538510391 | Mayu Winters | Registered Nurse | 853 Rosecrans St, San Diego, CA 92110 | 2016-06-23 |
1063870376 | Matthew O'connor | Registered Nurse | 3417 Front St, San Diego, CA 92103-4813 | 2016-02-01 |
1417320599 | Brittany Moore | Registered Nurse | 4335 Hamilton St Apt 6, San Diego, CA 92104-1271 | 2015-11-11 |
1174992812 | Farren Kelly Joynes | Registered Nurse | 6713 Waterman Ct, San Diego, CA 92111-6033 | 2015-09-23 |
1922476886 | Nichole Jimmi | Registered Nurse | 1670 Kettner Blvd, Apt 122, San Diego, CA 92101-2522 | 2015-09-09 |
1700158672 | Vitaly Juravsky | Registered Nurse | 3853 Rosecrans Street San Diego, Ca, San Diego, CA 92110 | 2012-02-07 |
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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.