Provider Demographics
NPI:1588019657
Name:HOTZ, JOSHUA WILLIAM (RN)
Entity Type:Individual
Prefix:
First Name:JOSHUA
Middle Name:WILLIAM
Last Name:HOTZ
Suffix:
Gender:M
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5810 EL CAMINO REAL
Mailing Address - Street 2:SUITE A
Mailing Address - City:CARLSBAD
Mailing Address - State:CA
Mailing Address - Zip Code:92008-8819
Mailing Address - Country:US
Mailing Address - Phone:760-929-8269
Mailing Address - Fax:
Practice Address - Street 1:5810 EL CAMINO REAL
Practice Address - Street 2:SUITE A
Practice Address - City:CARLSBAD
Practice Address - State:CA
Practice Address - Zip Code:92008-8819
Practice Address - Country:US
Practice Address - Phone:760-929-8269
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-04-26
Last Update Date:2016-04-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA95084116163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse