Healthcare Provider Details

I. General information

NPI: 1093627887
Provider Name (Legal Business Name): DONNA Z TENORIO
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 09/17/2026
Last Update Date: 09/17/2026
Certification Date: 09/17/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1400 EMELINE AVE # 1976
SANTA CRUZ CA
95060-1976
US

IV. Provider business mailing address

1520 CAPITOLA RD # 1202
SANTA CRUZ CA
95062-2969
US

V. Phone/Fax

Practice location:
  • Phone: 831-454-4170
  • Fax:
Mailing address:
  • Phone: 831-707-3388
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363AM0700X
TaxonomyMedical Physician Assistant
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: