Provider Demographics
NPI:1063188670
Name:LAHUYNH, JONATHAN (APRN)
Entity type:Individual
Prefix:
First Name:JONATHAN
Middle Name:
Last Name:LAHUYNH
Suffix:
Gender:
Credentials:APRN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4225 EXECUTIVE SQ STE 450
Mailing Address - Street 2:
Mailing Address - City:LA JOLLA
Mailing Address - State:CA
Mailing Address - Zip Code:92037-8411
Mailing Address - Country:US
Mailing Address - Phone:858-798-6123
Mailing Address - Fax:
Practice Address - Street 1:8851 CENTER DR STE 505
Practice Address - Street 2:
Practice Address - City:LA MESA
Practice Address - State:CA
Practice Address - Zip Code:91942-3059
Practice Address - Country:US
Practice Address - Phone:619-461-3880
Practice Address - Fax:619-461-3895
Is Sole Proprietor?:No
Enumeration Date:2021-08-23
Last Update Date:2025-05-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA832724163W00000X
CA95033986363LA2100X, 363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
No163W00000XNursing Service ProvidersRegistered Nurse
No363LA2100XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAcute Care