Provider Demographics
NPI:1942069554
Name:MOFFITT, ALINA S (NP)
Entity Type:Individual
Prefix:
First Name:ALINA
Middle Name:S
Last Name:MOFFITT
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Mailing Address - Street 1:6166 PRINTWOOD WAY
Mailing Address - Street 2:
Mailing Address - City:SAN DIEGO
Mailing Address - State:CA
Mailing Address - Zip Code:92117-3345
Mailing Address - Country:US
Mailing Address - Phone:619-890-0277
Mailing Address - Fax:
Practice Address - Street 1:1320 E MADISON AVE
Practice Address - Street 2:
Practice Address - City:EL CAJON
Practice Address - State:CA
Practice Address - Zip Code:92021-8531
Practice Address - Country:US
Practice Address - Phone:619-456-9800
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-03-18
Last Update Date:2024-03-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA95029451363LP2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP2300XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPrimary Care