Basic Information
| Provider Information | |||||||||
| NPI: | 1023160132 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | FROMM | ||||||||
| FirstName: | LEORA | ||||||||
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| Credential: | RN, CNM | ||||||||
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| Mailing Information | |||||||||
| Address1: | 1505 SOQUEL DR | ||||||||
| Address2: | STE 7 | ||||||||
| City: | SANTA CRUZ | ||||||||
| State: | CA | ||||||||
| PostalCode: | 950651716 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8314764200 | ||||||||
| FaxNumber: | 8314765052 | ||||||||
| Practice Location | |||||||||
| Address1: | 1595 SOQUEL DR | ||||||||
| Address2: | STE 220 | ||||||||
| City: | SANTA CRUZ | ||||||||
| State: | CA | ||||||||
| PostalCode: | 950651719 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8314764200 | ||||||||
| FaxNumber: | 8314765052 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 01/17/2007 | ||||||||
| LastUpdateDate: | 08/30/2017 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 163W00000X | 533171 | CA | N | Nursing Service Providers | Registered Nurse | 367A00000X | 1405 | CA | Y | Physician Assistants & Advanced Practice Nursing Providers | Advanced Practice Midwife |
No ID Information.