Provider Demographics
NPI:1871031286
Name:SANTOS, EUGELYN OPALEC (DNP, FNP-BC, CPNP)
Entity Type:Individual
Prefix:DR
First Name:EUGELYN
Middle Name:OPALEC
Last Name:SANTOS
Suffix:
Gender:F
Credentials:DNP, FNP-BC, CPNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7830 CLAIREMONT MESA BLVD.
Mailing Address - Street 2:SUITE 100
Mailing Address - City:SAN DIEGO
Mailing Address - State:CA
Mailing Address - Zip Code:92111-1619
Mailing Address - Country:US
Mailing Address - Phone:858-268-1111
Mailing Address - Fax:858-268-0761
Practice Address - Street 1:15611 POMERADO RD STE 400
Practice Address - Street 2:
Practice Address - City:POWAY
Practice Address - State:CA
Practice Address - Zip Code:92064-2437
Practice Address - Country:US
Practice Address - Phone:858-675-3100
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-02-06
Last Update Date:2018-04-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA95004815363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner