Healthcare Provider Details

I. General information

NPI: 1760913263
Provider Name (Legal Business Name): ELIZABETH BENNETT DOWD NP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/26/2017
Last Update Date: 06/19/2026
Certification Date: 06/19/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2185 W GRANT LINE RD
TRACY CA
95377-7309
US

IV. Provider business mailing address

2185 W GRANT LINE RD
TRACY CA
95377-7309
US

V. Phone/Fax

Practice location:
  • Phone: 800-464-4000
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License NumberRN2299351
License Number StateMA
# 2
Primary TaxonomyN
Taxonomy Code363LW0102X
TaxonomyWomen's Health Nurse Practitioner
License NumberRN2299351
License Number StateMA
# 3
Primary TaxonomyN
Taxonomy Code363LP2300X
TaxonomyPrimary Care Nurse Practitioner
License NumberRN2299351
License Number StateMA
# 4
Primary TaxonomyY
Taxonomy Code363LW0102X
TaxonomyWomen's Health Nurse Practitioner
License Number95007017
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: