Data from the NPPES registry. May not reflect recent changes — verify at nppes.cms.hhs.gov.
JODIE FASULLO, RN
Active Sole ProprietorJODIE FASULLO, RN is a Nutrition Support Nurse healthcare provider located in SAN CLEMENTE, California. NPI 1154885655 is currently active in the NPPES registry. Verify at CMS.
Nutrition Support Nurse · SAN CLEMENTE, CA
Registration Details
- NPI Number
- 1154885655
- Provider Type
- Individual
- Gender
- Female
- NPI Issued
- Jan 29, 2019 (7.5698731510584 yrs)
- Last Updated
- Jan 29, 2019
- License
-
718632 (CA)
- Sole Proprietor
- Yes
Practice Information
- Address
-
37 OPTIMASAN CLEMENTE, CA, 926729407Browse CA providers · Browse ZIP 92672
- Phone
- 9498133026
- Primary Specialty
-
Nutrition Support Nurse
163WN1003X
Other Nutrition Support Nurse Providers in SAN CLEMENTE, CA
| Name | Credential | NPI |
|---|---|---|
| KRISTYNA DORRIS | RN | 1639826423 |
Data sourced from the NPPES National Provider Identifier registry. This information is for informational purposes only and is not a substitute for verifying credentials with the appropriate licensing authority. For official verification, use the NPPES NPI Registry or the relevant state medical board.