Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.

Jodie Fasullo, RN

Individual provider Nutrition Support Registered Nurse · NPI 1154885655

Jodie Fasullo, RN is a Nutrition Support Registered Nurse in San Clemente, California. Practices as a sole proprietor and works from 2 locations. Licensed in California.

Licensed in
CA
In the registry since
2019
What do these letters mean?
RN — Registered Nurse
A licensed nurse who completed a nursing degree and passed the NCLEX-RN examination.

See every abbreviation used in this directory →

Practice location Address checks out

37 Optima
San Clemente, CA 92672-9407
Phone: (949) 813-3026
Show map & directions

Pin is approximate — placed at the ZIP-code centre, not the exact door.

Additional practice locations (1)

  • 22600 Lambert St Ste 802b, Lake Forest, CA 92630-1620 — (949) 813-3026

Specialties & licences

Nutrition Support Registered Nurse (primary) Taxonomy 163WN1003X · Licence 718632 (CA)

Record details

NPI number1154885655
Entity typeIndividual (Type 1)
GenderFemale
Credentials RN
Sole proprietorYes
NPI enumeratedJanuary 29, 2019
Last updated in NPPESJanuary 29, 2019

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