Basic Information
| Provider Information | |||||||||
| NPI: | 1821194051 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | KUNSELMAN | ||||||||
| FirstName: | ELIZABETH | ||||||||
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| Credential: | N.P. | ||||||||
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| Mailing Information | |||||||||
| Address1: | 2350 W EL CAMINO REAL | ||||||||
| Address2: | FL 2 | ||||||||
| City: | MOUNTAIN VIEW | ||||||||
| State: | CA | ||||||||
| PostalCode: | 940406201 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6509343546 | ||||||||
| FaxNumber: | 6506916193 | ||||||||
| Practice Location | |||||||||
| Address1: | 815 BAY AVE | ||||||||
| Address2: | |||||||||
| City: | CAPITOLA | ||||||||
| State: | CA | ||||||||
| PostalCode: | 950102106 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6509343546 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 09/15/2006 | ||||||||
| LastUpdateDate: | 01/27/2017 | ||||||||
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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 | 363L00000X | 16286 | CA | Y | Physician Assistants & Advanced Practice Nursing Providers | Nurse Practitioner |
No ID Information.