Kudulis, Deanna Lynn

Kudulis, Deanna Lynn is an individual health care provider with primary practice located at 8831 Villa La Jolla Dr , La Jolla CA 92037-1949. She recently has only one registered license in Physician Assistants & Advanced Practice Nursing Providers / Family, which is considered as her primary health care specialty. Kudulis, Deanna Lynn can be contacted via phone (858) 457-4480.

Contact Information

Primary practice address
8831 Villa La Jolla Dr La Jolla CA 92037-1949
Phone: (858) 457-4480
Fax:
Website:
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Health care specialties

SpecialtyCodeLicense #State
Physician Assistants & Advanced Practice Nursing Providers / Family 363LF0000X 15849 California

Profile Details

NPI number 1285715052
LBN Legal business name Kudulis, Deanna Lynn
Credentials Nurse Practitioner (NP)
Entity Individual
Sole proprietor 1 No
Enumeration date Oct 18th, 2006
Last updated Jun 12th, 2019 - about 5 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1285715052 NPPES
California MEDICAID 1285715052

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