Individual
MS. CARMEN BALLESTERO RODRIGUEZ
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
R.N.
Contact information
Practice address
2440 GRAND AVE, SAN DIEGO, CA 92109-4858
(858) 490-4400
(858) 490-4405
Mailing address
13746 PASEO CEVERA, SAN DIEGO, CA 92129-2762
(858) 538-5959
Taxonomy
Speciality
Code
Description
License number
State
163WC1500X
Community Health Registered Nurse
Primary
246636
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
163W00000X
REGISTERED NURSE
CA
Enumeration date
04/03/2007
Last updated
07/08/2007
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