Provider Demographics
NPI:1902692759
Name:DE NUNEZ, GUILLERMINA FREGOSO
Entity type:Individual
Prefix:
First Name:GUILLERMINA
Middle Name:FREGOSO
Last Name:DE NUNEZ
Suffix:
Gender:
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:910 PAULA ST
Mailing Address - Street 2:
Mailing Address - City:ESCONDIDO
Mailing Address - State:CA
Mailing Address - Zip Code:92027-1756
Mailing Address - Country:US
Mailing Address - Phone:760-893-9410
Mailing Address - Fax:
Practice Address - Street 1:3535 LINDA VISTA DR SPC 228
Practice Address - Street 2:
Practice Address - City:SAN MARCOS
Practice Address - State:CA
Practice Address - Zip Code:92078-6335
Practice Address - Country:US
Practice Address - Phone:760-594-0855
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-04-17
Last Update Date:2025-04-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3747P1801XNursing Service Related ProvidersTechnicianPersonal Care Attendant
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAA1948507OtherDRIVER LICENSE