Provider Demographics
NPI:1558233437
Name:DESTEFANO, EMILY PAIGE (ND)
Entity type:Individual
Prefix:
First Name:EMILY
Middle Name:PAIGE
Last Name:DESTEFANO
Suffix:
Gender:F
Credentials:ND
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3870 HIAWATHA WAY
Mailing Address - Street 2:
Mailing Address - City:SAN DIEGO
Mailing Address - State:CA
Mailing Address - Zip Code:92117-4643
Mailing Address - Country:US
Mailing Address - Phone:480-848-3887
Mailing Address - Fax:
Practice Address - Street 1:3870 HIAWATHA WAY
Practice Address - Street 2:
Practice Address - City:SAN DIEGO
Practice Address - State:CA
Practice Address - Zip Code:92117-4643
Practice Address - Country:US
Practice Address - Phone:480-848-3887
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-09-20
Last Update Date:2025-09-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes175F00000XOther Service ProvidersNaturopath