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NPI Code Detail

MEDICARE: MARY DUPASQUIER KNUDTSON NP

MEDICARE: MARY DUPASQUIER KNUDTSON 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
1363LF0000XFamily Nurse Practitioner381975CA

General Provider Information

NPI Number : 1902997463
Entity Type Code : Individual
Provider Name (Legal Business Name) : MARY DUPASQUIER KNUDTSON NP
Provider Business Mailing Address
First Line : 1004 RANCH VIEW RD
Second Line :
City : SANTA CRUZ
State : CA
Zip : 95064-1098
Country : US
Telephone Number : 562-760-3211
Fax Number :
Provider Business Practice Location Address
First Line : 1156 HIGH ST
Second Line : UCSC HEALTH CENTER
City : SANTA CRUZ
State : CA
Zip : 95064-1077
Country : US
Telephone Number : 831-459-2211
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 09/27/2006
Last Update Date : 03/07/2023

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