Provider Demographics
NPI:1578619813
Name:MERICA-JONES, SUSAN ALZINA (MSN CNM)
Entity Type:Individual
Prefix:
First Name:SUSAN
Middle Name:ALZINA
Last Name:MERICA-JONES
Suffix:
Gender:F
Credentials:MSN CNM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:15351 ISLA VISTA RD
Mailing Address - Street 2:
Mailing Address - City:JAMUL
Mailing Address - State:CA
Mailing Address - Zip Code:91935-3400
Mailing Address - Country:US
Mailing Address - Phone:619-669-3606
Mailing Address - Fax:
Practice Address - Street 1:5555 GROSSMONT CENTER DR
Practice Address - Street 2:SHARP GROSSMONT HOSPITAL WOMEN'S CENTER PRENATAL CLINIC
Practice Address - City:LA MESA
Practice Address - State:CA
Practice Address - Zip Code:91942-3019
Practice Address - Country:US
Practice Address - Phone:619-740-4721
Practice Address - Fax:619-740-4971
Is Sole Proprietor?:No
Enumeration Date:2007-01-27
Last Update Date:2007-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA336339163W00000X
CA5142363LX0001X
CANMW 7550367A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Not Answered163W00000XNursing Service ProvidersRegistered Nurse
Not Answered363LX0001XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerObstetrics & Gynecology
Not Answered367A00000XPhysician Assistants & Advanced Practice Nursing ProvidersAdvanced Practice Midwife
Provider Identifiers
StateIdentifier IDID TypeIssuer
CANMW007550Medicaid