Healthcare Provider Details

I. General information

NPI: 1578515961
Provider Name (Legal Business Name): TRESSA RAYE EDELMAN FNP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/16/2006
Last Update Date: 07/08/2026
Certification Date: 07/08/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1150 FOSTER AVE
ARCATA CA
95521-5986
US

IV. Provider business mailing address

ARCATA COMMUNITY HEALTH CENTER 1150 FOSTER AVE.
ARCATA CA
95521
US

V. Phone/Fax

Practice location:
  • Phone: 707-826-8610
  • Fax: 707-726-8610
Mailing address:
  • Phone: 707-862-8610
  • Fax: 707-826-8623

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License NumberSP033427
License Number StatePA
# 2
Primary TaxonomyN
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number607011
License Number StateTX
# 3
Primary TaxonomyN
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License Number607011
License Number StateTX
# 4
Primary TaxonomyY
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License NumberAP109151
License Number StateTX
# 5
Primary TaxonomyN
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License Number0101488
License Number StateCO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: