Provider Demographics
NPI:1407721574
Name:PREPETIT, ELISE C
Entity type:Individual
Prefix:
First Name:ELISE
Middle Name:C
Last Name:PREPETIT
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5069 UNIVERSITY AVE APT 8
Mailing Address - Street 2:
Mailing Address - City:SAN DIEGO
Mailing Address - State:CA
Mailing Address - Zip Code:92105-2161
Mailing Address - Country:US
Mailing Address - Phone:619-782-1656
Mailing Address - Fax:
Practice Address - Street 1:5069 UNIVERSITY AVE APT 8
Practice Address - Street 2:
Practice Address - City:SAN DIEGO
Practice Address - State:CA
Practice Address - Zip Code:92105-2161
Practice Address - Country:US
Practice Address - Phone:619-782-1656
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-10-08
Last Update Date:2025-10-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes374J00000XNursing Service Related ProvidersDoulaGroup - Single Specialty