Provider Demographics
NPI:1841900479
Name:FELIZ, JOAN D (FNP-BC, CCT, RCIS)
Entity type:Individual
Prefix:MR
First Name:JOAN
Middle Name:D
Last Name:FELIZ
Suffix:
Gender:M
Credentials:FNP-BC, CCT, RCIS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2655 CAMINO DEL RIO N
Mailing Address - Street 2:
Mailing Address - City:SAN DIEGO
Mailing Address - State:CA
Mailing Address - Zip Code:92108-1633
Mailing Address - Country:US
Mailing Address - Phone:312-341-0049
Mailing Address - Fax:
Practice Address - Street 1:2655 CAMINO DEL RIO N STE 120
Practice Address - Street 2:
Practice Address - City:SAN DIEGO
Practice Address - State:CA
Practice Address - Zip Code:92108-1633
Practice Address - Country:US
Practice Address - Phone:000-000-0000
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-12-05
Last Update Date:2023-03-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA95014288363LP2300X, 363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
No363LP2300XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPrimary Care