Provider Demographics
NPI:1134015571
Name:SALVADOR, MEGHAN-KIRSTIE (MSN, RN)
Entity type:Individual
Prefix:
First Name:MEGHAN-KIRSTIE
Middle Name:
Last Name:SALVADOR
Suffix:
Gender:X
Credentials:MSN, RN
Other - Prefix:
Other - First Name:MEGHAN
Other - Middle Name:
Other - Last Name:SALVADOR
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:MSN, RN
Mailing Address - Street 1:5555 GROSSMONT CENTER DR
Mailing Address - Street 2:
Mailing Address - City:LA MESA
Mailing Address - State:CA
Mailing Address - Zip Code:91942-3019
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:5555 GROSSMONT CENTER DR
Practice Address - Street 2:
Practice Address - City:LA MESA
Practice Address - State:CA
Practice Address - Zip Code:91942-3019
Practice Address - Country:US
Practice Address - Phone:619-945-3369
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-06-13
Last Update Date:2025-06-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA5173364S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes364S00000XPhysician Assistants & Advanced Practice Nursing ProvidersClinical Nurse Specialist