Provider Demographics
NPI:1326425331
Name:AXLER, DEANNA J (MA)
Entity Type:Individual
Prefix:MS
First Name:DEANNA
Middle Name:J
Last Name:AXLER
Suffix:
Gender:F
Credentials:MA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3525 DEL MAR HEIGHTS RD
Mailing Address - Street 2:SUITE 302
Mailing Address - City:SAN DIEGO
Mailing Address - State:CA
Mailing Address - Zip Code:92130-2199
Mailing Address - Country:US
Mailing Address - Phone:619-630-4611
Mailing Address - Fax:
Practice Address - Street 1:2202 COMSTOCK ST
Practice Address - Street 2:ATTN: CAPE
Practice Address - City:SAN DIEGO
Practice Address - State:CA
Practice Address - Zip Code:92111-6502
Practice Address - Country:US
Practice Address - Phone:858-278-0771
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2015-04-28
Last Update Date:2015-04-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program