Provider Demographics
NPI:1003464553
Name:NUNEZ, ALEXIS LISAMARI
Entity Type:Individual
Prefix:
First Name:ALEXIS
Middle Name:LISAMARI
Last Name:NUNEZ
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:308 SANTA INES WAY
Mailing Address - Street 2:
Mailing Address - City:OCEANSIDE
Mailing Address - State:CA
Mailing Address - Zip Code:92057-6857
Mailing Address - Country:US
Mailing Address - Phone:760-518-3120
Mailing Address - Fax:
Practice Address - Street 1:3365 TONOPAH ST
Practice Address - Street 2:
Practice Address - City:OCEANSIDE
Practice Address - State:CA
Practice Address - Zip Code:92054-3865
Practice Address - Country:US
Practice Address - Phone:760-757-5585
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-08-28
Last Update Date:2019-08-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3747A0650XNursing Service Related ProvidersTechnicianAttendant Care Provider