Jodie Fasullo, RN
NPI #1154885655 in San Clemente, California
Provider Information
- NPI Number
- 1154885655
- Entity Type
- Individual
- Name
- Jodie Fasullo, RN
- Gender
- Not Specified
- Sole Proprietor
- Yes
- Primary Specialty
- Registered Nurse - Nutrition Support
- Credential
- RN
- Enumeration Date
- Jan 29, 2019
- Last Updated
- Jan 29, 2019
Practice Location
- Address
- 37 OPTIMA
- City
- San Clemente
- State
- California
- ZIP Code
- 92672-9407
- Phone
- (949) 813-3026
Specialties & Taxonomy Codes
| Specialty |
|---|
| Registered Nurse - Nutrition Support — Nutrition Support |
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