Individual
JASETTE MARIAN MANACSA FONG
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
RN, APRN, MSN
Contact information
Practice address
34800 BOB WILSON DR, SAN DIEGO, CA 92134-1098
(619) 532-7049
Mailing address
1118 CAMINO CANTERA, CHULA VISTA, CA 91913-3451
(619) 548-0886
Taxonomy
Speciality
Code
Description
License number
State
163WP0200X
Pediatric Registered Nurse
753824
CA
364SP0200X
Pediatric Clinical Nurse Specialist
Primary
4666
CA
Other
Enumeration date
04/07/2023
Last updated
04/07/2023
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