Individual provider Active NPI

Kaitlyn Victoria Mudge, DNP, APRN

  • Family Nurse Practitioner
  • Chula Vista, CA
National Provider Identifier
1508772369
Registry record updated Aug 21, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
95040593 Issued in CA
Practice address
910 Hale PL Ste 110
Chula Vista, CA 91914-3598
Phone
(619) 704-7577
NPI assigned
Aug 21, 2026
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 21, 2026

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatric Nurse Practitioner 363LP0200X 95040593 CA
Family Nurse Practitioner 363LF0000X 95040593 CA Primary

Addresses

Primary practice location

910 Hale PL Ste 110
Chula Vista, CA 91914-3598

Mailing address

536 Via de la Valle Unit a
Solana Beach, CA 92075-2484
Phone (619) 704-7577

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

Practice roles

OrganizationSpecialtyStatusNew patients
Modena Allergy & Asthma II Inc. PastSince Dec 28, 2025 Accepting new patients
Modena Allergy & Asthma Inc. Past Accepting new patients

Organizations & group practices 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1787270400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1787270400000",
    "number": "1508772369",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "536 VIA DE LA VALLE UNIT A",
            "city": "SOLANA BEACH",
            "state": "CA",
            "postal_code": "920752484",
            "telephone_number": "619-704-7577"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "910 HALE PL STE 110",
            "city": "CHULA VISTA",
            "state": "CA",
            "postal_code": "919143598",
            "telephone_number": "619-704-7577"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MUDGE",
        "first_name": "KAITLYN",
        "middle_name": "VICTORIA",
        "credential": "DNP, APRN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2026-08-21",
        "last_updated": "2026-08-21",
        "certification_date": "2026-08-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Pediatrics",
            "state": "CA",
            "license": "95040593",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "CA",
            "license": "95040593",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Chula Vista, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 21, 2026; 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.