Provider Demographics
NPI:1295950228
Name:WORCESTER, DONNA S (FNP)
Entity type:Individual
Prefix:
First Name:DONNA
Middle Name:S
Last Name:WORCESTER
Suffix:
Gender:F
Credentials:FNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:4624 ROBBINS ST
Mailing Address - Street 2:
Mailing Address - City:SAN DIEGO
Mailing Address - State:CA
Mailing Address - Zip Code:92122-3035
Mailing Address - Country:US
Mailing Address - Phone:858-453-4638
Mailing Address - Fax:858-453-7452
Practice Address - Street 1:2017 1ST AVE
Practice Address - Street 2:SUITE 301
Practice Address - City:SAN DIEGO
Practice Address - State:CA
Practice Address - Zip Code:92101-2033
Practice Address - Country:US
Practice Address - Phone:619-881-4577
Practice Address - Fax:619-231-1031
Is Sole Proprietor?:No
Enumeration Date:2007-04-16
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA6017363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily