Provider Demographics
NPI:1306535745
Name:BARTELLONI, KATHLEEN ANN (LVN, HHP, CFNC)
Entity type:Individual
Prefix:
First Name:KATHLEEN
Middle Name:ANN
Last Name:BARTELLONI
Suffix:
Gender:F
Credentials:LVN, HHP, CFNC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:15326 CALLE JUANITO
Mailing Address - Street 2:
Mailing Address - City:SAN DIEGO
Mailing Address - State:CA
Mailing Address - Zip Code:92129-1013
Mailing Address - Country:US
Mailing Address - Phone:703-431-9021
Mailing Address - Fax:
Practice Address - Street 1:15326 CALLE JUANITO
Practice Address - Street 2:
Practice Address - City:SAN DIEGO
Practice Address - State:CA
Practice Address - Zip Code:92129-1013
Practice Address - Country:US
Practice Address - Phone:703-431-9021
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-05-02
Last Update Date:2023-06-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA689404164X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164X00000XNursing Service ProvidersLicensed Vocational Nurse