Provider Demographics
NPI:1740317247
Name:BUTTRON, JOY L
Entity type:Individual
Prefix:MRS
First Name:JOY
Middle Name:L
Last Name:BUTTRON
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 1:1700 PACIFIC HWY RM 107
Mailing Address - Street 2:
Mailing Address - City:SAN DIEGO
Mailing Address - State:CA
Mailing Address - Zip Code:92101-2417
Mailing Address - Country:US
Mailing Address - Phone:619-515-6625
Mailing Address - Fax:619-515-6644
Practice Address - Street 1:1700 PACIFIC HWY RM 107
Practice Address - Street 2:
Practice Address - City:SAN DIEGO
Practice Address - State:CA
Practice Address - Zip Code:92101-2417
Practice Address - Country:US
Practice Address - Phone:619-515-6625
Practice Address - Fax:619-515-6644
Is Sole Proprietor?:Yes
Enumeration Date:2007-02-28
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA495981163WC1500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WC1500XNursing Service ProvidersRegistered NurseCommunity Health