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Individual
EDRICK MATHIEU OTEYZA
Active
Individual
EDRICK MATHIEU OTEYZA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
NP
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
95078590
CA
363L00000X
Nurse Practitioner
Primary
95017112
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
95017112
NURSE PRACTITIONER FURNISHING
CA
01
—
95078590
REGISTERED NURSE LICENSE
CA
Enumeration date
07/29/2021
Last updated
08/17/2026
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