Provider Demographics
NPI:1104710334
Name:FINNERTY, ERIN SHEA (NP)
Entity type:Individual
Prefix:
First Name:ERIN
Middle Name:SHEA
Last Name:FINNERTY
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3706 HAINES ST
Mailing Address - Street 2:
Mailing Address - City:SAN DIEGO
Mailing Address - State:CA
Mailing Address - Zip Code:92109-6620
Mailing Address - Country:US
Mailing Address - Phone:615-428-6484
Mailing Address - Fax:
Practice Address - Street 1:1425 FRAZEE RD
Practice Address - Street 2:
Practice Address - City:SAN DIEGO
Practice Address - State:CA
Practice Address - Zip Code:92108-4347
Practice Address - Country:US
Practice Address - Phone:619-293-7233
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-06-03
Last Update Date:2025-06-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
261QM2500X
CA95034329261QM2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM2500XAmbulatory Health Care FacilitiesClinic/CenterMedical Specialty