Provider Demographics
NPI:1194350967
Name:KINGSBURY, LETISHA KATHLEEN (RN)
Entity type:Individual
Prefix:MRS
First Name:LETISHA
Middle Name:KATHLEEN
Last Name:KINGSBURY
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:LETISHA
Other - Middle Name:KATHLEEN
Other - Last Name:ARCOS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:724 GRANADA DR
Mailing Address - Street 2:
Mailing Address - City:VISTA
Mailing Address - State:CA
Mailing Address - Zip Code:92083-4731
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:724 GRANADA DR
Practice Address - Street 2:
Practice Address - City:VISTA
Practice Address - State:CA
Practice Address - Zip Code:92083-4731
Practice Address - Country:US
Practice Address - Phone:951-719-0109
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-03-11
Last Update Date:2020-03-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA555959163WC1500X
CA95098353163WM0705X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WM0705XNursing Service ProvidersRegistered NurseMedical-Surgical
No163WC1500XNursing Service ProvidersRegistered NurseCommunity Health