Provider Demographics
NPI:1144769886
Name:HUNSAKER, NALANI HAVILAND (MCMSC, PA-C)
Entity Type:Individual
Prefix:
First Name:NALANI
Middle Name:HAVILAND
Last Name:HUNSAKER
Suffix:
Gender:F
Credentials:MCMSC, PA-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:625 W. CITRACADO PKWY
Mailing Address - Street 2:#112
Mailing Address - City:ESCONDIDO
Mailing Address - State:CA
Mailing Address - Zip Code:92025
Mailing Address - Country:US
Mailing Address - Phone:877-567-2627
Mailing Address - Fax:
Practice Address - Street 1:625 W. CITRACADO PKWY
Practice Address - Street 2:#112
Practice Address - City:ESCONDIDO
Practice Address - State:CA
Practice Address - Zip Code:92025
Practice Address - Country:US
Practice Address - Phone:877-567-2627
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-02-14
Last Update Date:2020-09-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA54218363AM0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AM0700XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantMedical