Provider Demographics
NPI:1699977272
Name:ESER, MARIA GRACIA BAUTISTA (RN)
Entity type:Individual
Prefix:
First Name:MARIA GRACIA
Middle Name:BAUTISTA
Last Name:ESER
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:GRACE
Other - Middle Name:B
Other - Last Name:ESER
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:RN
Mailing Address - Street 1:6961 DYLAN ST
Mailing Address - Street 2:
Mailing Address - City:SAN DIEGO
Mailing Address - State:CA
Mailing Address - Zip Code:92139-2110
Mailing Address - Country:US
Mailing Address - Phone:619-479-2246
Mailing Address - Fax:
Practice Address - Street 1:9065 EDGEMOOR DR
Practice Address - Street 2:
Practice Address - City:SANTEE
Practice Address - State:CA
Practice Address - Zip Code:92071-2110
Practice Address - Country:US
Practice Address - Phone:619-479-2246
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-06-05
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CARN462693164W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164W00000XNursing Service ProvidersLicensed Practical Nurse