Healthcare Provider Details

I. General information

NPI: 1376922773
Provider Name (Legal Business Name): ERICA SCOTT NP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/19/2015
Last Update Date: 03/07/2023
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

131 STONY CIR STE 1600
SANTA ROSA CA
95401-9520
US

IV. Provider business mailing address

2350 W EL CAMINO REAL FL 2
MOUNTAIN VIEW CA
94040-6203
US

V. Phone/Fax

Practice location:
  • Phone: 707-541-7700
  • Fax: 707-573-5415
Mailing address:
  • Phone: 707-541-7700
  • Fax: 707-573-5415

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number95001633
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: