Individual provider · Type 1 NPI

Maryellen Boczar Green, F.N.P.

Student in an Organized Health Care Education/Training Program · San Diego, CA

NPI number 1285817924 Active

Practice location

5500 Campanile Dr, Sdsu Student Health Services
San Diego, CA 92182-0001

Call (619) 594-5281 Map

Fax (619) 594-3638

Mailing address

5500 Campanile Drive, Student Health Services
San Diego, CA 92182-4701

Specialties and licenses

TaxonomyCodeLicense
Student in an Organized Health Care Education/Training Program Primary 390200000X347863 (CA)

Student in an Organized Health Care Education/Training Program: An individual who is enrolled in an organized health care education/training program leading to a degree, certification, registration, and/or licensure to provide health care.

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About NPI 1285817924

Maryellen Boczar Green, F.N.P.'s National Provider Identifier is 1285817924, issued on Dec 17, 2007. The primary taxonomy on file is Student in an Organized Health Care Education/Training Program (390200000X), and the practice location is in San Diego, CA. The record was last updated on Dec 17, 2007.