Provider Demographics
NPI:1750713947
Name:SEWALL, NALA ANA ALAN (NP)
Entity type:Individual
Prefix:
First Name:NALA ANA
Middle Name:ALAN
Last Name:SEWALL
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:460 WESTBOURNE ST
Mailing Address - Street 2:
Mailing Address - City:LA JOLLA
Mailing Address - State:CA
Mailing Address - Zip Code:92037-5347
Mailing Address - Country:US
Mailing Address - Phone:619-246-9165
Mailing Address - Fax:
Practice Address - Street 1:320 SANTA FE DR STE 204
Practice Address - Street 2:
Practice Address - City:ENCINITAS
Practice Address - State:CA
Practice Address - Zip Code:92024-5179
Practice Address - Country:US
Practice Address - Phone:760-944-7300
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2013-07-30
Last Update Date:2013-07-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA17335363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily