Provider Demographics
NPI:1346640588
Name:CHITILA JAMES, PHOEBE (NP)
Entity Type:Individual
Prefix:
First Name:PHOEBE
Middle Name:
Last Name:CHITILA JAMES
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:PHOEBE
Other - Middle Name:N'GONGA
Other - Last Name:CHITILA
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:NP
Mailing Address - Street 1:2125 CITRACADO PKWY
Mailing Address - Street 2:
Mailing Address - City:ESCONDIDO
Mailing Address - State:CA
Mailing Address - Zip Code:92029-4159
Mailing Address - Country:US
Mailing Address - Phone:858-675-3100
Mailing Address - Fax:
Practice Address - Street 1:2125 CITRACADO PKWY
Practice Address - Street 2:
Practice Address - City:ESCONDIDO
Practice Address - State:CA
Practice Address - Zip Code:92029-4159
Practice Address - Country:US
Practice Address - Phone:858-675-3100
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2014-08-25
Last Update Date:2021-11-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAAP60670305363LF0000X
CA95001134363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily