Individual
MRS. DAISIANETTE HODGE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
RN
Contact information
Practice address
1250 MORENA BLVD, SAN DIEGO, CA 92110-3815
(619) 692-8750
(619) 692-8779
Mailing address
8510 LARKDALE AVE, SAN DIEGO, CA 92123-2050
(601) 212-5022
Taxonomy
Speciality
Code
Description
License number
State
163WP0809X
Adult Psychiatric/Mental Health Registered Nurse
Primary
95169891
CA
164X00000X
Licensed Vocational Nurse
686560
CA
Other
Enumeration date
03/27/2017
Last updated
09/17/2018
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