Individual provider · Type 1 NPI

Stephanie Tanya Randall, NP

Family Nurse Practitioner · San Diego, CA

NPI number 1104590025 Active

Practice location

5160 Federal Blvd
San Diego, CA 92105

Mailing address

823 Gateway Center Way
San Diego, CA 92102-4541

Specialties and licenses

TaxonomyCodeLicense
Family Nurse Practitioner Primary 363LF0000X95017990 (CA)

Family Nurse Practitioner: Definition to come...

6 other providers at this address

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About NPI 1104590025

Stephanie Tanya Randall, NP's National Provider Identifier is 1104590025, issued on Aug 4, 2021. The primary taxonomy on file is Family Nurse Practitioner (363LF0000X), and the practice location is in San Diego, CA. The record was last updated on Jun 3, 2024.