Provider Demographics
NPI:1811716129
Name:WORLEY, MAKAYLA ELISE (NP)
Entity type:Individual
Prefix:
First Name:MAKAYLA
Middle Name:ELISE
Last Name:WORLEY
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:MAKAYLA
Other - Middle Name:ELISE
Other - Last Name:MARCO
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:10790 RANCHO BERNARDO RD
Mailing Address - Street 2:
Mailing Address - City:SAN DIEGO
Mailing Address - State:CA
Mailing Address - Zip Code:92127-5705
Mailing Address - Country:US
Mailing Address - Phone:858-764-3000
Mailing Address - Fax:
Practice Address - Street 1:3811 VALLEY CENTRE DR # S99
Practice Address - Street 2:
Practice Address - City:SAN DIEGO
Practice Address - State:CA
Practice Address - Zip Code:92130-3318
Practice Address - Country:US
Practice Address - Phone:858-764-3000
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-10-04
Last Update Date:2024-11-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA95031536363LP0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPediatrics