Healthcare Provider Details

I. General information

NPI: 1952603896
Provider Name (Legal Business Name): AMY ELIZABETH THATCHER NP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 11/29/2010
Last Update Date: 06/12/2026
Certification Date: 06/12/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

324 W EL SEGUNDO BLVD
EL SEGUNDO CA
90245-3635
US

IV. Provider business mailing address

333 1ST ST STE A
SAN FRANCISCO CA
94105-2661
US

V. Phone/Fax

Practice location:
  • Phone: 310-615-5259
  • Fax: 310-615-5917
Mailing address:
  • Phone: 888-803-3370
  • Fax: 888-803-3331

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LA2100X
TaxonomyAcute Care Nurse Practitioner
License Number20138
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: