Individual
MISS EILEEN MARIE DONNELLY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA
Contact information
Practice address
1510 CAPITOLA RD, SANTA CRUZ, CA 95062-2912
(831) 427-3500
Mailing address
PO BOX 542, SANTA CRUZ, CA 95061-0542
(831) 427-3500
Taxonomy
Speciality
Code
Description
License number
State
363AM0700X
Medical Physician Assistant
Primary
PA11304
CA
Other
Enumeration date
11/17/2006
Last updated
12/07/2022
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