Provider Demographics
NPI:1255868873
Name:PATRICIA VLASIN, N.P., INC., A NURSING CORPORATION
Entity type:Organization
Organization Name:PATRICIA VLASIN, N.P., INC., A NURSING CORPORATION
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:CHAIRMAN
Authorized Official - Prefix:
Authorized Official - First Name:PATRICIA
Authorized Official - Middle Name:
Authorized Official - Last Name:VLASIN
Authorized Official - Suffix:
Authorized Official - Credentials:NP
Authorized Official - Phone:619-602-6351
Mailing Address - Street 1:9921 CARMEL MTN RD #430
Mailing Address - Street 2:
Mailing Address - City:SAN DIEGO
Mailing Address - State:CA
Mailing Address - Zip Code:92129-2813
Mailing Address - Country:US
Mailing Address - Phone:619-602-6351
Mailing Address - Fax:858-901-4873
Practice Address - Street 1:13754 BASSMORE DR
Practice Address - Street 2:
Practice Address - City:SAN DIEGO
Practice Address - State:CA
Practice Address - Zip Code:92129-3220
Practice Address - Country:US
Practice Address - Phone:619-602-6351
Practice Address - Fax:858-901-4873
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-05-13
Last Update Date:2017-05-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CANP9662363LG0600X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363LG0600XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerGerontologyGroup - Single Specialty