Provider Demographics
NPI:1760511273
Name:CHASE, DONNA KATHERINE (RN, PHN)
Entity Type:Individual
Prefix:MS
First Name:DONNA
Middle Name:KATHERINE
Last Name:CHASE
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 1:2440 GRAND AVE
Mailing Address - Street 2:
Mailing Address - City:SAN DIEGO
Mailing Address - State:CA
Mailing Address - Zip Code:92109-4858
Mailing Address - Country:US
Mailing Address - Phone:858-292-5872
Mailing Address - Fax:858-490-4405
Practice Address - Street 1:2440 GRAND AVE
Practice Address - Street 2:
Practice Address - City:SAN DIEGO
Practice Address - State:CA
Practice Address - Zip Code:92109-4858
Practice Address - Country:US
Practice Address - Phone:858-292-5872
Practice Address - Fax:858-490-4405
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-02
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CARN523979163W00000X, 163WC0400X, 163WC1500X, 163WM0102X, 163WP0200X, 163WP1700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Not Answered163W00000XNursing Service ProvidersRegistered Nurse
Not Answered163WC0400XNursing Service ProvidersRegistered NurseCase Management
Not Answered163WC1500XNursing Service ProvidersRegistered NurseCommunity Health
Not Answered163WM0102XNursing Service ProvidersRegistered NurseMaternal Newborn
Not Answered163WP0200XNursing Service ProvidersRegistered NursePediatrics
Not Answered163WP1700XNursing Service ProvidersRegistered NursePerinatal