JODIE FASULLO (NPI# 1154885655) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1154885655 |
| Entity Type | Individual |
| Full Name | JODIE FASULLO |
| Credential | RN |
| Practice Address |
37 Optima San Clemente CA 92672-9407 |
| Practice Telephone | 9498133026 |
| Mailing Telephone | 9498133026 |
| Enumeration Date | 2019-01-29 |
| Last Update Date | 2019-01-29 |
| Gender Code | F |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 163WN1003X |
Registered Nurse Specialization: Nutrition Support |
718632 | CA | Nursing Service Providers |
| Address | Telephone Number | Fax Number |
|---|---|---|
| 22600 Lambert St Ste 802b, Lake Forest, CA 926301620 | 9498133026 |
| Street Address |
37 OPTIMA |
| City | SAN CLEMENTE |
| State | CA |
| Zip Code | 92672-9407 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1497355234 | Julie Case | Massage Therapist | 205 Via Presa, I Do Not Work From Home- I Am A Contractor, San Clemente, CA 92672 | 2020-10-30 |
| 1396213971 | Kirtney So Lim | Military Health Care Provider | 62 Area San Mateo Naval Clinic, Camp Pendleton, CA 92672 | 2018-11-13 |
| 1407322258 | Lodie Ikeda | Non-emergency Medical Transport (VAN) | 119 Avenida Dolores B, San Clemente, CA 92672 | 2018-10-19 |
| 1629566245 | I-ting Wang | Counselor | 3551 Camino Mira Costa San Clemente, Suite T, San Clemente, CA 92672 | 2018-04-30 |
| 1174046874 | Russell Thompson Chiropractic Inc | Clinic/Center | 629 Camino De Los Mares, Ste. 104, San Clemente, CA 92672 | 2017-07-25 |
| 1518320415 | Addiction Health Alliance LLC | Clinical Medical Laboratory | 605 Avenida Las Flores, San Clemente, CA 92672 | 2016-03-30 |
| 1871961342 | Paul Van Zeumeren | Marriage & Family Therapist | 2715 Calle Del Comercio, Unit C, San Clemente, CA 92672 | 2015-09-14 |
| 1194043596 | Sima Moayed | Pharmacist | 801 N. Elcamino Real, San Clemente, CA 92672 | 2010-05-10 |
| 1942539432 | Martha Elena Hall | Acupuncturist | 131 W. El Portal, San Clemente, CA 92672 | 2009-12-14 |
| 1922334515 | Katie B Mann | Social Worker | 1401 N. El Camino Real, #100, San Clemente, CA 92672 | 2009-11-02 |
| Find all providers in zip 92672 | ||||
| Taxonomy Code | 163WN1003X |
| Grouping | Nursing Service Providers |
| Classification | Registered Nurse |
| Specialization | Nutrition Support |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1558982306 | Zermina Akbary | Registered Nurse | 131 Theme, Irvine, Irvine, CA 92618 | 2020-05-04 |
| 1427584986 | Maria Tamara Valdez | Registered Nurse | 4930 Del Mar Ave, Unit 105, San Diego, CA 92107-3424 | 2017-05-03 |
| 1225557747 | Yvonne Dejesus Enriquez | Registered Nurse | 300 S Highland Springs Ave, Banning, CA 92220-6504 | 2017-09-15 |
| 1497190045 | Patricia M Bianchi | Registered Nurse | 2333 N California St, Ste B, Stockton, CA 95204-5530 | 2013-05-08 |
| 1073716171 | Marlene Dolores Akin | Registered Nurse | 750 S Bascom Ave, Diabetes Education, San Jose, CA 95128-2603 | 2007-06-06 |
| 1306049416 | Mary Ann Fiamingo | Registered Nurse | 750 S Bascom Ave, Diabetes Ed, San Jose, CA 95128-2603 | 2007-06-06 |
| 1649473752 | Maria Dej Ramirez | Registered Nurse | 750 S Bascom Ave, Diabetes Ed, San Jose, CA 95128-2603 | 2007-06-06 |
| City | SAN CLEMENTE |
| Zip Code | 92672 |
Please comment or provide details below to improve the information on JODIE FASULLO.
| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.