Provider Demographics
NPI:1114310216
Name:ASMUS, THERESA (FNP-BC)
Entity type:Individual
Prefix:DR
First Name:THERESA
Middle Name:
Last Name:ASMUS
Suffix:
Gender:F
Credentials:FNP-BC
Other - Prefix:
Other - First Name:THERESA
Other - Middle Name:
Other - Last Name:LA GUARDIA
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:10155 PACIFIC HEIGHTS BLVD.
Mailing Address - Street 2:
Mailing Address - City:SAN DIEGO
Mailing Address - State:CA
Mailing Address - Zip Code:92121
Mailing Address - Country:US
Mailing Address - Phone:858-651-5918
Mailing Address - Fax:858-622-1658
Practice Address - Street 1:10155 PACIFIC HEIGHTS BLVD.
Practice Address - Street 2:
Practice Address - City:SAN DIEGO
Practice Address - State:CA
Practice Address - Zip Code:92121
Practice Address - Country:US
Practice Address - Phone:858-651-5918
Practice Address - Fax:858-622-1658
Is Sole Proprietor?:No
Enumeration Date:2015-03-12
Last Update Date:2024-07-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA95002039363LF0000X
CANP95002039363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily