Provider Demographics
NPI:1558758193
Name:DUCA, PATRICIA (RN, PHN, BSN)
Entity Type:Individual
Prefix:MS
First Name:PATRICIA
Middle Name:
Last Name:DUCA
Suffix:
Gender:F
Credentials:RN, PHN, BSN
Other - Prefix:MS
Other - First Name:PATRICIA
Other - Middle Name:
Other - Last Name:DUCA
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:RN, PHN, BSN
Mailing Address - Street 1:3805 FERN FLAT RD
Mailing Address - Street 2:
Mailing Address - City:APTOS
Mailing Address - State:CA
Mailing Address - Zip Code:95003-2657
Mailing Address - Country:US
Mailing Address - Phone:831-662-0562
Mailing Address - Fax:
Practice Address - Street 1:3805 FERN FLAT RD
Practice Address - Street 2:
Practice Address - City:APTOS
Practice Address - State:CA
Practice Address - Zip Code:95003-2657
Practice Address - Country:US
Practice Address - Phone:831-662-0562
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2015-04-21
Last Update Date:2015-04-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CARN336567163W00000X, 163WC0400X, 163WH0200X, 163WN0003X, 163WP0200X
CARN 336567 PHN 61169163WC1500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse
No163WC0400XNursing Service ProvidersRegistered NurseCase Management
No163WH0200XNursing Service ProvidersRegistered NurseHome Health
No163WN0003XNursing Service ProvidersRegistered NurseNeonatal, Low-Risk
No163WP0200XNursing Service ProvidersRegistered NursePediatrics
No163WC1500XNursing Service ProvidersRegistered NurseCommunity Health