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Individual

MS. EMILY P OTTO

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
NP

Contact information

Practice address
1555 SOQUEL DR, SANTA CRUZ, CA 95065-1705
(831) 462-7581
Mailing address
1555 SOQUEL DR, SANTA CRUZ, CA 95065-1705

Taxonomy

Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
632238
CA
363LA2100X
Acute Care Nurse Practitioner
Primary
95007121
CA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
269329
CA
Enumeration date
04/19/2017
Last updated
10/22/2017
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