Basic Information
| Provider Information | |||||||||
| NPI: | 1073241618 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | CHOI | ||||||||
| FirstName: | NATHALIE | ||||||||
| MiddleName: | LIJENZKA | ||||||||
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| Credential: | NP, CNM | ||||||||
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| Mailing Information | |||||||||
| Address1: | PO BOX 6536 | ||||||||
| Address2: | |||||||||
| City: | OCEANSIDE | ||||||||
| State: | CA | ||||||||
| PostalCode: | 920526536 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 4173424960 | ||||||||
| FaxNumber: | |||||||||
| Practice Location | |||||||||
| Address1: | 2185 CITRACADO PKWY | ||||||||
| Address2: | |||||||||
| City: | ESCONDIDO | ||||||||
| State: | CA | ||||||||
| PostalCode: | 920294159 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 4422815000 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 08/11/2022 | ||||||||
| LastUpdateDate: | 08/11/2022 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | Y | ||||||||
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| NPICertificationDate: | 08/11/2022 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 363LW0102X | 95022088 | CA | N | Physician Assistants & Advanced Practice Nursing Providers | Nurse Practitioner | Women's Health | 367A00000X | 236292 | CA | Y | 193400000X SINGLE SPECIALTY GROUP | Physician Assistants & Advanced Practice Nursing Providers | Advanced Practice Midwife |
ID Information
| ID | Type | State | Issuer | Description | 236292 | 05 | CA | MEDICAID | 95022088 | 01 | CA | PRIVATE INSUARNCE | OTHER | 236292 | 01 | CA | PRIVATE INSURANCE | OTHER | 95022088 | 05 | CA | MEDICAID |