Basic Information
| Provider Information | |||||||||
| NPI: | 1871611384 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | ADAMS | ||||||||
| FirstName: | PATRICIA | ||||||||
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| Credential: | RN/CDE | ||||||||
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| Mailing Information | |||||||||
| Address1: | 2025 SOQUEL AVE | ||||||||
| Address2: | |||||||||
| City: | SANTA CRUZ | ||||||||
| State: | CA | ||||||||
| PostalCode: | 950621323 | ||||||||
| CountryCode: | US | ||||||||
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| Practice Location | |||||||||
| Address1: | 815 BAY AVE. | ||||||||
| Address2: | SUITE B | ||||||||
| City: | CAPITOLA | ||||||||
| State: | CA | ||||||||
| PostalCode: | 950102186 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8314607333 | ||||||||
| FaxNumber: | 8314586999 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 03/26/2007 | ||||||||
| LastUpdateDate: | 10/24/2012 | ||||||||
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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 | 133NN1002X | 20210520 | CA | N | Dietary & Nutritional Service Providers | Nutritionist | Nutrition, Education | 163W00000X | 343869 | CA | Y | Nursing Service Providers | Registered Nurse |
No ID Information.