Provider Demographics
NPI:1669671293
Name:SUTERA, JOSEPHINE JOY (RN)
Entity Type:Individual
Prefix:
First Name:JOSEPHINE
Middle Name:JOY
Last Name:SUTERA
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:910 SYCAMORE AVE
Mailing Address - Street 2:SUITE 102
Mailing Address - City:VISTA
Mailing Address - State:CA
Mailing Address - Zip Code:92081-7832
Mailing Address - Country:US
Mailing Address - Phone:760-598-1700
Mailing Address - Fax:
Practice Address - Street 1:910 SYCAMORE AVE
Practice Address - Street 2:SUITE 102
Practice Address - City:VISTA
Practice Address - State:CA
Practice Address - Zip Code:92081-7832
Practice Address - Country:US
Practice Address - Phone:760-598-1700
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-07-13
Last Update Date:2007-07-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA288231163WX0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WX0200XNursing Service ProvidersRegistered NurseOncology