Provider Demographics
NPI:1073639092
Name:HOLTZ, PAULA JEAN (PHD,, RN, NP)
Entity Type:Individual
Prefix:DR
First Name:PAULA
Middle Name:JEAN
Last Name:HOLTZ
Suffix:
Gender:F
Credentials:PHD,, RN, NP
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Other - Middle Name:
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Mailing Address - Street 1:1412 ESCALONA DR
Mailing Address - Street 2:
Mailing Address - City:SANTA CRUZ
Mailing Address - State:CA
Mailing Address - Zip Code:95060-3310
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:UNIVERSITY OF CALIFORNIA SANTA CRUZ STUDENT HEALTH
Practice Address - Street 2:1156 HIGH ST.
Practice Address - City:SANTA CRUZ
Practice Address - State:CA
Practice Address - Zip Code:95064
Practice Address - Country:US
Practice Address - Phone:831-459-2869
Practice Address - Fax:831-469-3546
Is Sole Proprietor?:No
Enumeration Date:2007-03-21
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
CAPSY 20299103T00000X
CA309149163W00000X
CA10750363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Not Answered103T00000XBehavioral Health & Social Service ProvidersPsychologist
Not Answered163W00000XNursing Service ProvidersRegistered Nurse
Not Answered363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health