Provider Demographics
NPI:1194058883
Name:NAVARRETTE, JOHN PAUL (RN, MLT(ASCP))
Entity type:Individual
Prefix:MR
First Name:JOHN
Middle Name:PAUL
Last Name:NAVARRETTE
Suffix:
Gender:M
Credentials:RN, MLT(ASCP)
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1563 VIA OTANO
Mailing Address - Street 2:
Mailing Address - City:OCEANSIDE
Mailing Address - State:CA
Mailing Address - Zip Code:92056-5665
Mailing Address - Country:US
Mailing Address - Phone:760-724-9793
Mailing Address - Fax:
Practice Address - Street 1:1563 VIA OTANO
Practice Address - Street 2:
Practice Address - City:OCEANSIDE
Practice Address - State:CA
Practice Address - Zip Code:92056-5665
Practice Address - Country:US
Practice Address - Phone:760-724-9793
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-09-11
Last Update Date:2009-09-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NMRN-69832163W00000X
NM04209369291U00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes291U00000XLaboratoriesClinical Medical Laboratory
No163W00000XNursing Service ProvidersRegistered Nurse