Individual provider Active NPI

Charissa Philip

  • Registered Nurse
  • San Diego, CA
National Provider Identifier
1871498063
Registry record updated Oct 10, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Registered NurseTaxonomy code 163W00000X
License
95456122 Issued in CA
Practice address
2865 Logan Ave
San Diego, CA 92113-2411
Phone
(619) 232-4357
NPI assigned
Oct 9, 2026
Last updated
Oct 10, 2026By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 10, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Registered Nurse 163W00000X 95456122 CA Primary

Addresses

Primary practice location

2865 Logan Ave
San Diego, CA 92113-2411

Mailing address

12710 Belle Fleur Way
San Diego, CA 92128-4194
Phone (858) 705-2763

Medicare participation

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

NPI Registry JSON

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

{
    "created_epoch": "1791504000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1791590400000",
    "number": "1871498063",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12710 BELLE FLEUR WAY",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921284194",
            "telephone_number": "858-705-2763"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2865 LOGAN AVE",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921132411",
            "telephone_number": "619-232-4357"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PHILIP",
        "first_name": "CHARISSA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2026-10-09",
        "last_updated": "2026-10-10",
        "certification_date": "2026-10-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "CA",
            "license": "95456122",
            "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 Oct 10, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.

Verify at the official NPI Registry.