Healthcare Provider Details

I. General information

NPI: 1902607468
Provider Name (Legal Business Name): ELOISE KROPP RN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/21/2025
Last Update Date: 03/21/2025
Certification Date: 03/21/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

9200 SCRANTON RD
SAN DIEGO CA
92121-7716
US

IV. Provider business mailing address

402 VISTA WAY
OCEANSIDE CA
92054-6437
US

V. Phone/Fax

Practice location:
  • Phone: 888-406-4801
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code163WP0200X
TaxonomyPediatric Registered Nurse
License Number95411867
License Number StateCA
# 2
Primary TaxonomyN
Taxonomy Code163WP0200X
TaxonomyPediatric Registered Nurse
License Number221437
License Number StateOK
# 3
Primary TaxonomyN
Taxonomy Code163WS0200X
TaxonomySchool Registered Nurse
License Number95411867
License Number StateCA
# 4
Primary TaxonomyY
Taxonomy Code163WP2201X
TaxonomyAmbulatory Care Registered Nurse
License Number95411867
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: