Deanna Lynn Kudulis, NP

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

15849 Issued in CA

Practice address

8831 Villa la Jolla Dr
La Jolla, CA 92037-1949

Phone

(858) 457-4480

NPI assigned

Oct 18, 2006

Sex

Female

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Antelope Valley Emergency Medical Associates Inc

  • Emergency Medicine Physician
  • Lancaster, CA
  • NPI 1225054257
  NPD (past)
• Coastal Communities Physician Network, Inc.

  • Health Maintenance Organization
  • San Luis Obispo, CA
  • NPI 1275735011
  NPD (past)

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1161129600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1560297600000",
    "number": "1285715052",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8831 VILLA LA JOLLA DR",
            "city": "LA JOLLA",
            "state": "CA",
            "postal_code": "920371949",
            "telephone_number": "661-972-5317"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8831 VILLA LA JOLLA DR",
            "city": "LA JOLLA",
            "state": "CA",
            "postal_code": "920371949",
            "telephone_number": "858-457-4480"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KUDULIS",
        "first_name": "DEANNA",
        "middle_name": "LYNN",
        "name_prefix": "Ms.",
        "credential": "NP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-10-18",
        "last_updated": "2019-06-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "CA",
            "license": "15849",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1285715052",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Emily Anne Kruse, MD
• Esther Kuan
• Rebecca Kuan
• Christine Kubeck, PA-C
• Kathleen A Kubo, LCSW
• Kula Wellness Psychological Corp
• John G. Kuldau, M.D.
• Agnes Kulesza, CCP
• Anna Andranik Kulidjian, MD, MSC, FRCSC
• Nishat Kulkarni, MD

• Family Nurse Practitioner in La Jolla, CA
• Providers in La Jolla, CA by specialty
• Family Nurse Practitioner in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 12, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.