Individual
MADISON WEISS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
RN
Contact information
Practice address
3250 COUNTRY ROSE CIR, ENCINITAS, CA 92024-5708
(619) 639-7325
Mailing address
1166 PARK BLVD APT 211, SAN DIEGO, CA 92101-5620
(619) 919-9919
Taxonomy
Speciality
Code
Description
License number
State
163WA0400X
Addiction (Substance Use Disorder) Registered Nurse
Primary
95144643
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
95144643
REGISTERED NURSE
CA
Enumeration date
05/10/2019
Last updated
05/10/2019
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