Individual provider · Type 1 NPI
Jodie Fasullo, RN
Nutrition Support Registered Nurse · San Clemente, CA
NPI number
1154885655
Active
Practice location
37 Optima
San Clemente, CA 92672-9407
Other practice locations
- 22600 Lambert St Ste 802B, Lake Forest, CA 92630-1620 · (949) 813-3026
Specialties and licenses
| Taxonomy | Code | License |
|---|---|---|
| Nutrition Support Registered Nurse Primary | 163WN1003X | 718632 (CA) |
Nutrition Support Registered Nurse: Definition to come...
Other nutrition support registered nurse providers in San Clemente
About NPI 1154885655
Jodie Fasullo, RN's National Provider Identifier is 1154885655, issued on Jan 29, 2019. The primary taxonomy on file is Nutrition Support Registered Nurse (163WN1003X), and the practice location is in San Clemente, CA. The record was last updated on Jan 29, 2019.