Healthcare Provider Details

I. General information

NPI: 1477476026
Provider Name (Legal Business Name): ALICIA NEROMDE
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/31/2026
Last Update Date: 07/31/2026
Certification Date: 07/31/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1600 GREEN HILLS RD STE 101
SCOTTS VALLEY CA
95066-4981
US

IV. Provider business mailing address

1600 GREEN HILLS RD STE 101
SCOTTS VALLEY CA
95066-4981
US

V. Phone/Fax

Practice location:
  • Phone: 831-430-2552
  • Fax:
Mailing address:
  • Phone: 831-430-2552
  • Fax: 831-430-5850

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License Number813348
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: