Mary Fjerstad, NP

Primary specialty

Nurse PractitionerTaxonomy code 363L00000X

License

5578 Issued in CA

Practice address

1075 Camino del Rio S
San Diego, CA 92108-3538

Phone

(619) 881-4500

Fax

(619) 291-0255

NPI assigned

Apr 18, 2007

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

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Nurse Practitioner

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

{
    "created_epoch": "1176854400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1649497272",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1151 BELLVINE TRL",
            "city": "EL CAJON",
            "state": "CA",
            "postal_code": "920193278",
            "telephone_number": "619-593-4163",
            "fax_number": "619-334-3379"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1075 CAMINO DEL RIO S",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921083538",
            "telephone_number": "619-881-4500",
            "fax_number": "619-291-0255"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FJERSTAD",
        "first_name": "MARY",
        "name_prefix": "Ms.",
        "credential": "NP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-04-18",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "CA",
            "license": "5578",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Five Star Rehabilitation and Wellness Services, LLC. (Ageility Physical Therapy Solutions at The Remington Club)
• Five Star Remington Club LLC (Remington Club Health Center)
• Fix Body Group
• Fix Medical Group PC
• James R Fix, PSY.D.
• Elise Suttner Flachman, DNP, FNP-C
• Cherl Sonali Flack, PTA
• Leonard Flagg, H.H.P., M.T.
• Carolyn De Jesus Flagstad, PHARMACY TECHNICIAN
• Daniel Michael Flaherty Jr., DO

• Nurse Practitioner in San Diego, CA
• Providers in San Diego, CA by specialty
• Nurse Practitioner in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.