Individual
JALIL DAKISSAGA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
RN, BSN
Contact information
Practice address
3853 ROSECRANS ST, SAN DIEGO, CA 92110-3115
(619) 692-8232
Mailing address
7850 VISTA HILL AVE, SAN DIEGO, CA 92123-2717
(858) 836-8434
Taxonomy
Speciality
Code
Description
License number
State
163WP0808X
Psychiatric/Mental Health Registered Nurse
95177720
CA
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
95033164
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1639432768
—
CA
Enumeration date
06/22/2012
Last updated
12/19/2024
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