Provider Demographics
NPI:1518503218
Name:PFAFF, ARLENE (RN, PHN)
Entity Type:Individual
Prefix:
First Name:ARLENE
Middle Name:
Last Name:PFAFF
Suffix:
Gender:F
Credentials:RN, PHN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7071 LEICESTER ST
Mailing Address - Street 2:
Mailing Address - City:SAN DIEGO
Mailing Address - State:CA
Mailing Address - Zip Code:92120-1237
Mailing Address - Country:US
Mailing Address - Phone:619-988-3254
Mailing Address - Fax:619-220-6403
Practice Address - Street 1:7947 MISSION CENTER CT
Practice Address - Street 2:
Practice Address - City:SAN DIEGO
Practice Address - State:CA
Practice Address - Zip Code:92108-1440
Practice Address - Country:US
Practice Address - Phone:619-767-5192
Practice Address - Fax:619-220-6403
Is Sole Proprietor?:No
Enumeration Date:2019-11-18
Last Update Date:2019-11-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA554560163WC1500X
CA831551163WG0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WC1500XNursing Service ProvidersRegistered NurseCommunity Health
No163WG0000XNursing Service ProvidersRegistered NurseGeneral Practice