Provider Demographics
NPI:1881208064
Name:SEGUIN, JONI JAYNE
Entity Type:Individual
Prefix:
First Name:JONI JAYNE
Middle Name:
Last Name:SEGUIN
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:315 BROOKSTONE PL
Mailing Address - Street 2:
Mailing Address - City:SANTEE
Mailing Address - State:CA
Mailing Address - Zip Code:92071-6914
Mailing Address - Country:US
Mailing Address - Phone:619-764-1148
Mailing Address - Fax:
Practice Address - Street 1:675 E BRADLEY AVE
Practice Address - Street 2:
Practice Address - City:EL CAJON
Practice Address - State:CA
Practice Address - Zip Code:92021-3110
Practice Address - Country:US
Practice Address - Phone:619-448-6633
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-09-03
Last Update Date:2020-09-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA95030377163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse