Provider Demographics
NPI:1073912614
Name:GARVIN, CASSANDRA (DNP, FNP-BC)
Entity Type:Individual
Prefix:DR
First Name:CASSANDRA
Middle Name:
Last Name:GARVIN
Suffix:
Gender:F
Credentials:DNP, FNP-BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:11425 EL CAMINO REAL
Mailing Address - Street 2:
Mailing Address - City:SAN DIEGO
Mailing Address - State:CA
Mailing Address - Zip Code:92130-2045
Mailing Address - Country:US
Mailing Address - Phone:858-794-6363
Mailing Address - Fax:619-350-3593
Practice Address - Street 1:11425 EL CAMINO REAL
Practice Address - Street 2:
Practice Address - City:SAN DIEGO
Practice Address - State:CA
Practice Address - Zip Code:92130-2045
Practice Address - Country:US
Practice Address - Phone:858-794-6363
Practice Address - Fax:619-350-3593
Is Sole Proprietor?:No
Enumeration Date:2014-08-20
Last Update Date:2023-09-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA95019915363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily