Individual provider Active NPI

Redentor Patrocinio Sese

  • Administrator Registered Nurse
  • San Diego, CA
National Provider Identifier
1508372095
Registry record updated Dec 19, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Administrator Registered NurseTaxonomy code 163WA2000X
License
633846 Issued in CA
Practice address
6915 Glenflora Ave
San Diego, CA 92119-2945
Phone
(619) 463-5757
Fax
(619) 463-5757
NPI assigned
Dec 19, 2017
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Dec 19, 2017

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Administrator Registered Nurse 163WA2000X 633846 CA Primary

Addresses

Primary practice location

6915 Glenflora Ave
San Diego, CA 92119-2945

Mailing address

633 Port Trinity
Chula Vista, CA 91913-1227
Phone (619) 254-5951

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
633846CAMDAdministrator Registered Nurse

NPI Registry JSON

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

{
    "created_epoch": "1513641600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1513641600000",
    "number": "1508372095",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "633 PORT TRINITY",
            "city": "CHULA VISTA",
            "state": "CA",
            "postal_code": "919131227",
            "telephone_number": "619-254-5951"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6915 GLENFLORA AVE",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921192945",
            "telephone_number": "619-463-5757",
            "fax_number": "619-463-5757"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SESE",
        "first_name": "REDENTOR",
        "middle_name": "PATROCINIO",
        "name_prefix": "Mr.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2017-12-19",
        "last_updated": "2017-12-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163WA2000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, Administrator",
            "state": "CA",
            "license": "633846",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in San Diego, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 19, 2017; 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.