Provider Demographics
NPI:1437771367
Name:MAULA, MARIE ANN SY (RN, BSN, PHN)
Entity Type:Individual
Prefix:MRS
First Name:MARIE ANN
Middle Name:SY
Last Name:MAULA
Suffix:
Gender:F
Credentials:RN, BSN, PHN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9376 GALVIN AVE
Mailing Address - Street 2:
Mailing Address - City:SAN DIEGO
Mailing Address - State:CA
Mailing Address - Zip Code:92126-4890
Mailing Address - Country:US
Mailing Address - Phone:619-246-0440
Mailing Address - Fax:
Practice Address - Street 1:9376 GALVIN AVE
Practice Address - Street 2:
Practice Address - City:SAN DIEGO
Practice Address - State:CA
Practice Address - Zip Code:92126-4890
Practice Address - Country:US
Practice Address - Phone:619-246-0440
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-05-14
Last Update Date:2020-05-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA641205163WX0601X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WX0601XNursing Service ProvidersRegistered NurseOtorhinolaryngology & Head-Neck