Provider Demographics
NPI:1174037451
Name:TROITSKAYA, EKATERINA (FNP-C)
Entity Type:Individual
Prefix:
First Name:EKATERINA
Middle Name:
Last Name:TROITSKAYA
Suffix:
Gender:F
Credentials:FNP-C
Other - Prefix:
Other - First Name:EKATERINA
Other - Middle Name:
Other - Last Name:KENT
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:FNP-C
Mailing Address - Street 1:325 DISTEL CIR
Mailing Address - Street 2:
Mailing Address - City:LOS ALTOS
Mailing Address - State:CA
Mailing Address - Zip Code:94022-1408
Mailing Address - Country:US
Mailing Address - Phone:650-691-6174
Mailing Address - Fax:
Practice Address - Street 1:2581 SAMARITAN DR STE 202
Practice Address - Street 2:
Practice Address - City:SAN JOSE
Practice Address - State:CA
Practice Address - Zip Code:95124-4112
Practice Address - Country:US
Practice Address - Phone:408-358-3939
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-11-26
Last Update Date:2019-10-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CANP95007663363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner