Provider Demographics
NPI:1861889370
Name:FEIZI, SEDI (FNP)
Entity type:Individual
Prefix:
First Name:SEDI
Middle Name:
Last Name:FEIZI
Suffix:
Gender:F
Credentials:FNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:17161 ALVA RD UNIT 3324
Mailing Address - Street 2:
Mailing Address - City:SAN DIEGO
Mailing Address - State:CA
Mailing Address - Zip Code:92127-2154
Mailing Address - Country:US
Mailing Address - Phone:858-900-8165
Mailing Address - Fax:
Practice Address - Street 1:17161 ALVA ROAD
Practice Address - Street 2:3324
Practice Address - City:SAN DIEGO
Practice Address - State:CA
Practice Address - Zip Code:92127
Practice Address - Country:US
Practice Address - Phone:858-900-8165
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2015-04-22
Last Update Date:2015-04-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA95002309163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse