Basic Information
| Provider Information | |||||||||
| NPI: | 1710082490 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | LITWILER | ||||||||
| FirstName: | HELEN | ||||||||
| MiddleName: | M. | ||||||||
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| Credential: | NP | ||||||||
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| Mailing Information | |||||||||
| Address1: | 1400 EMELINE AVE | ||||||||
| Address2: | |||||||||
| City: | SANTA CRUZ | ||||||||
| State: | CA | ||||||||
| PostalCode: | 950601976 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8314544170 | ||||||||
| FaxNumber: | 8314544663 | ||||||||
| Practice Location | |||||||||
| Address1: | 1400 EMELINE AVE | ||||||||
| Address2: | |||||||||
| City: | SANTA CRUZ | ||||||||
| State: | CA | ||||||||
| PostalCode: | 950601976 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8314544170 | ||||||||
| FaxNumber: | 8314544663 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 09/14/2006 | ||||||||
| LastUpdateDate: | 05/21/2009 | ||||||||
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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 | 106H00000X | MFT 27928 | CA | N | Behavioral Health & Social Service Providers | Marriage & Family Therapist | 163W00000X | 309342 | CA | N | Nursing Service Providers | Registered Nurse | 363L00000X | 550 | CA | Y | Physician Assistants & Advanced Practice Nursing Providers | Nurse Practitioner |
ID Information
| ID | Type | State | Issuer | Description | ZZZ92073Z | 01 | CA | MEDICARE GROUP ID# | OTHER | MFT 27928 | 01 | CA | OTHER LICENSE | OTHER | ZZZ92069Z | 01 | CA | MEDICARE GROUP ID# | OTHER | 1659315430 | 01 | CA | ENTITY NPI# | OTHER | NP 550 | 01 | CA | NURSE PRACTITIONER # | OTHER | RN 309342 | 01 | CA | REGISTERED NURSE # | OTHER | ZZZ91892Z | 01 | CA | MEDICARE GROUP ID# | OTHER | ZZZ91891Z | 01 | CA | MEDICARE GROUP ID# | OTHER |