Provider Demographics
NPI:1003305145
Name:ADVANCED PRACTICE CLINICIANS NURSING SERVICES
Entity Type:Organization
Organization Name:ADVANCED PRACTICE CLINICIANS NURSING SERVICES
Other - Org Name:ADVANCED PRACTICE CLINICIANS
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:DR
Authorized Official - First Name:KEVIN
Authorized Official - Middle Name:
Authorized Official - Last Name:LETZ
Authorized Official - Suffix:
Authorized Official - Credentials:NP
Authorized Official - Phone:650-924-1174
Mailing Address - Street 1:654 SEA ANCHOR DR UNIT 2305
Mailing Address - Street 2:
Mailing Address - City:REDWOOD CITY
Mailing Address - State:CA
Mailing Address - Zip Code:94063-2896
Mailing Address - Country:US
Mailing Address - Phone:650-924-1174
Mailing Address - Fax:877-992-9814
Practice Address - Street 1:654 SEA ANCHOR DR UNIT 2305
Practice Address - Street 2:
Practice Address - City:REDWOOD CITY
Practice Address - State:CA
Practice Address - Zip Code:94063-2896
Practice Address - Country:US
Practice Address - Phone:650-924-1174
Practice Address - Fax:877-992-9814
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-05-03
Last Update Date:2018-05-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental HealthGroup - Multi-Specialty
No363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamilyGroup - Multi-Specialty
No363LG0600XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerGerontologyGroup - Multi-Specialty