Provider Demographics
NPI:1225012842
Name:SATTERWHITE, MAURINE C (NP)
Entity Type:Individual
Prefix:MS
First Name:MAURINE
Middle Name:C
Last Name:SATTERWHITE
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 1:6973 LINDA VISTA RD
Mailing Address - Street 2:
Mailing Address - City:SAN DIEGO
Mailing Address - State:CA
Mailing Address - Zip Code:92111-6339
Mailing Address - Country:US
Mailing Address - Phone:858-279-9676
Mailing Address - Fax:858-279-0377
Practice Address - Street 1:6973 LINDA VISTA RD
Practice Address - Street 2:
Practice Address - City:SAN DIEGO
Practice Address - State:CA
Practice Address - Zip Code:92111-6339
Practice Address - Country:US
Practice Address - Phone:858-279-9676
Practice Address - Fax:858-279-0377
Is Sole Proprietor?:No
Enumeration Date:2005-12-06
Last Update Date:2009-02-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA7022363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
CABH924ZMedicare UPIN
S57152Medicare UPIN
CAWNP70222AMedicare ID - Type UnspecifiedPPIN