Individual
ROBERT VICKERS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
1400 EMELINE AVE, SANTA CRUZ, CA 95060-1976
(831) 454-4971
Mailing address
1400 EMELINE AVE, SANTA CRUZ, CA 95060-1976
(831) 454-4971
Taxonomy
Speciality
Code
Description
License number
State
225400000X
Rehabilitation Practitioner
Primary
—
—
372600000X
Adult Companion
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
ZZZ91891Z
COUNTY OF SANTA CRUZ MEDICARE GROUP PTAN#
CA
01
—
ZZZ91892Z
COUNTY OF SANTA CRUZ MEDICARE GROUP PTAN#
CA
01
—
ZZZ92069Z
COUNTY OF SANTA CRUZ MEDICARE GROUP PTAN#
CA
Enumeration date
04/20/2012
Last updated
05/27/2026
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