person
Jodie Fasullo, RN
Nutrition Support Registered Nurse in San Clemente, California
NPI 1154885655

Jodie Fasullo is a Nutrition Support Registered Nurse based in San Clemente, CA and is specialized in Nutrition Support. Jodie Fasullo practices in San Clemente, CA and has the professional credentials of RN. The NPI Number for Jodie Fasullo is 1154885655 and holds a License No. 718632 (California).

The current practice location address for Jodie Fasullo is 37 Optima, San Clemente, CA and can be reached out via phone at 949-813-3026.

Location: 37 Optima, San Clemente, CA, 92672-9407
person
Provider Profile Details
NPI Number
1154885655
Provider Name
Jodie Fasullo
Credential
RN
Provider Entity Type
Individual
Gender
Female
Address
37 Optima, San Clemente, CA, 92672-9407
Phone Number
949-813-3026
Fax Number
Provider Enumeration Date
01/29/2019
Last Update Date
03/10/2024
institution
Provider Business Practice Location Address Details
Address
37 Optima
City
State
Zip
92672-9407
Phone Number
949-813-3026
Fax Number
person
Provider Business Mailing Address Details
Address
37 Optima
City
State
Zip
92672-9407
Phone Number
949-813-3026
Fax Number
person
Provider's Taxonomy Details 1
Type
Nursing Service Providers
Classification
Registered Nurse
Speciality
Nutrition Support
Taxonomy
License No.
718632 (California)
Definition
Definition to come...
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