Provider Demographics
NPI:1255300562
Name:RYCHNOVSKY, JACQUELINE D (PHD, RN, CPNP)
Entity Type:Individual
Prefix:DR
First Name:JACQUELINE
Middle Name:D
Last Name:RYCHNOVSKY
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Gender:F
Credentials:PHD, RN, CPNP
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Mailing Address - Street 1:1848 LAGRANGE ROAD
Mailing Address - Street 2:
Mailing Address - City:CHULA VISTA
Mailing Address - State:CA
Mailing Address - Zip Code:91913-1680
Mailing Address - Country:US
Mailing Address - Phone:619-889-8545
Mailing Address - Fax:619-934-4760
Practice Address - Street 1:34800 BOB WILSON DR
Practice Address - Street 2:NAVAL MEDICAL CENTER
Practice Address - City:SAN DIEGO
Practice Address - State:CA
Practice Address - Zip Code:92134-1098
Practice Address - Country:US
Practice Address - Phone:619-532-8234
Practice Address - Fax:619-532-8137
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-03-17
Last Update Date:2007-07-08
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Provider Licenses
StateLicense IDTaxonomies
CA12380363LP0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPediatrics