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Individual

JESSICA NIETO

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
MD

Contact information

Practice address
NAVAL MEDICAL CENTER SAN DIEGO 38400 BOB WILSON DRIVE, SAN DIEGO, CA 92134-5000
(816) 721-0055
Mailing address
34800 BOB WILSON DR, SAN DIEGO, CA 92134-1098
(619) 532-8963

Taxonomy

Speciality
Code
Description
License number
State
171000000X
Military Health Care Provider
207L00000X
Anesthesiology Physician
0101267957
VA
207L00000X
Anesthesiology Physician
Primary
A199364
CA
208D00000X
General Practice Physician
0101267957
VA

Other

Enumeration date
03/26/2018
Last updated
08/13/2025
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