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Individual

EMILY RENEE MORENO

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
FNP

Contact information

Practice address
1552 NIGHTFALL LN, CHULA VISTA, CA 91915-1950
(619) 518-2438
(619) 428-7952
Mailing address
4004 BEYER BLVD, SAN YSIDRO, CA 92173-2007
(619) 662-4100
(619) 428-7952

Taxonomy

Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
1678229
CO
363L00000X
Nurse Practitioner
599565
CA
363LF0000X
Family Nurse Practitioner
0997112-NP
CO
363LP0200X
Pediatric Nurse Practitioner
0997112-NP
CO
363LP0200X
Pediatric Nurse Practitioner
Primary
22468
CA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
0106141-NP
RXN
CO
01
0997112-NP
NURSE PRACTITIONER/APN
CO
01
1396098562
NPI NUMBER
CA
01
1678229
RN
CO
01
22468
NURSE PRACTITIONER FURNISHING/ CERTITFICATE
CA
01
599565
MEDICAL LICENSE
CA
Enumeration date
10/24/2012
Last updated
07/13/2023
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