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NPI Code Detail

MEDICARE: MRS. ELLI NICHOLE ROBERTS

MEDICARE: MRS. ELLI NICHOLE ROBERTS
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1175T00000XPeer SpecialistCA

General Provider Information

NPI Number : 1952249815
Entity Type Code : Individual
Provider Name (Legal Business Name) : MRS. ELLI NICHOLE ROBERTS
Provider Business Mailing Address
First Line : 49 BLANCA LN SPC 404
Second Line :
City : WATSONVILLE
State : CA
Zip : 95076-2150
Country : US
Telephone Number : 831-888-6078
Fax Number :
Provider Business Practice Location Address
First Line : 380 ENCINAL ST STE 200
Second Line :
City : SANTA CRUZ
State : CA
Zip : 95060-2178
Country : US
Telephone Number : 831-888-6078
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 03/23/2026
Last Update Date : 03/23/2026

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Directions to “ MRS. ELLI NICHOLE ROBERTS ” Practice Location

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