Basic Information
| Provider Information | |||||||||
| NPI: | 1326631359 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | HUNTER | ||||||||
| FirstName: | JASON | ||||||||
| MiddleName: | FRANKLIN | ||||||||
| NamePrefix: | |||||||||
| NameSuffix: | I | ||||||||
| Credential: | RN, PHN | ||||||||
| OtherOrganizationName: | |||||||||
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| Mailing Information | |||||||||
| Address1: | 330 MOSS ST | ||||||||
| Address2: | |||||||||
| City: | CHULA VISTA | ||||||||
| State: | CA | ||||||||
| PostalCode: | 919112005 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6194266310 | ||||||||
| FaxNumber: | |||||||||
| Practice Location | |||||||||
| Address1: | 330 MOSS ST | ||||||||
| Address2: | |||||||||
| City: | CHULA VISTA | ||||||||
| State: | CA | ||||||||
| PostalCode: | 919112005 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6194266310 | ||||||||
| FaxNumber: | |||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 02/20/2021 | ||||||||
| LastUpdateDate: | 02/20/2021 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
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| NPICertificationDate: | 02/12/2021 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 163WC1500X | 558031 | CA | N | Nursing Service Providers | Registered Nurse | Community Health | 163W00000X | 95147690 | CA | Y | Nursing Service Providers | Registered Nurse |
No ID Information.