Individual
DARRELL VINCECRUZ DEGUZMAN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
PMHNP, FNP
Contact information
Practice address
1061 TIERRA DEL REY STE 200, CHULA VISTA, CA 91910
(619) 498-5454
(619) 528-4625
Mailing address
PO BOX 609001, SAN DIEGO, CA 92160-9001
(619) 528-4600
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
95008025
CA
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
NP95008025
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
W416
—
CA
Enumeration date
11/20/2018
Last updated
05/13/2021
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