Provider Demographics
NPI:1154695500
Name:LOPEZ-NUSSER, ALEXANDRA SASCHA (RN)
Entity type:Individual
Prefix:
First Name:ALEXANDRA
Middle Name:SASCHA
Last Name:LOPEZ-NUSSER
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9400 RUFFIN CT
Mailing Address - Street 2:BLDG B
Mailing Address - City:SAN DIEGO
Mailing Address - State:CA
Mailing Address - Zip Code:92123-5300
Mailing Address - Country:US
Mailing Address - Phone:858-514-4655
Mailing Address - Fax:858-514-4656
Practice Address - Street 1:9400 RUFFIN CT
Practice Address - Street 2:BLDG B
Practice Address - City:SAN DIEGO
Practice Address - State:CA
Practice Address - Zip Code:92123-5300
Practice Address - Country:US
Practice Address - Phone:858-514-4655
Practice Address - Fax:858-514-4656
Is Sole Proprietor?:No
Enumeration Date:2012-03-02
Last Update Date:2012-03-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA577233163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse