Provider Demographics
NPI:1699535278
Name:BYERS, MICHELLE Y (RN)
Entity type:Individual
Prefix:MS
First Name:MICHELLE
Middle Name:Y
Last Name:BYERS
Suffix:
Gender:F
Credentials:RN
Other - Prefix:MS
Other - First Name:MICHELLE
Other - Middle Name:Y
Other - Last Name:BERRY
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:RN
Mailing Address - Street 1:1598 VILLA CREST DR
Mailing Address - Street 2:
Mailing Address - City:EL CAJON
Mailing Address - State:CA
Mailing Address - Zip Code:92021-3666
Mailing Address - Country:US
Mailing Address - Phone:805-903-3911
Mailing Address - Fax:
Practice Address - Street 1:1341 N ESCONDIDO BLVD
Practice Address - Street 2:
Practice Address - City:ESCONDIDO
Practice Address - State:CA
Practice Address - Zip Code:92026-2507
Practice Address - Country:US
Practice Address - Phone:619-209-3696
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-03-20
Last Update Date:2024-03-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA590101163WA0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WA0400XNursing Service ProvidersRegistered NurseAddiction (Substance Use Disorder)