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NPI Code Detail

MEDICARE: MISS HELENA POBLADOR NORRIS MSN NP

MEDICARE: MISS HELENA POBLADOR NORRIS MSN NP
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1363L00000XNurse Practitioner274100CA

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
11053483008OTHERCANPI

General Provider Information

NPI Number : 1053483008
Entity Type Code : Individual
Provider Name (Legal Business Name) : MISS HELENA POBLADOR NORRIS MSN NP
Provider Business Mailing Address
First Line : 1665 DOMINICAN WAY STE 222
Second Line :
City : SANTA CRUZ
State : CA
Zip : 95065-1515
Country : US
Telephone Number : 831-465-0586
Fax Number : 866-264-3890
Provider Business Practice Location Address
First Line : 1665 DOMINICAN WAY STE 222
Second Line :
City : SANTA CRUZ
State : CA
Zip : 95065-1515
Country : US
Telephone Number : 844-387-5337
Fax Number : 866-264-3890
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 11/14/2006
Last Update Date : 02/21/2017

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