Individual
AGNES Y MORTISON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
R.N. P.H.N.
Contact information
Practice address
6160 MISSION GORGE RD, SUITE 400, SAN DIEGO, CA 92120-3410
(619) 528-4000
Mailing address
17867 SUN WALK CT, SAN DIEGO, CA 92127-1370
(858) 675-0564
Taxonomy
Speciality
Code
Description
License number
State
163WC0400X
Case Management Registered Nurse
Primary
335001
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
335001
R.N LICENSE
CA
Enumeration date
03/15/2007
Last updated
07/08/2007
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