Provider Demographics
NPI:1144826132
Name:HOPPING SANTOS, NICOLE MARIE (RN)
Entity type:Individual
Prefix:
First Name:NICOLE
Middle Name:MARIE
Last Name:HOPPING SANTOS
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:NICOLE
Other - Middle Name:HOPPING
Other - Last Name:JONES
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:111 BEAN CREEK RD UNIT 111
Mailing Address - Street 2:
Mailing Address - City:SCOTTS VALLEY
Mailing Address - State:CA
Mailing Address - Zip Code:95066-4148
Mailing Address - Country:US
Mailing Address - Phone:510-870-1670
Mailing Address - Fax:
Practice Address - Street 1:125 WATER ST STE A2
Practice Address - Street 2:
Practice Address - City:SANTA CRUZ
Practice Address - State:CA
Practice Address - Zip Code:95060-2786
Practice Address - Country:US
Practice Address - Phone:831-427-3500
Practice Address - Fax:831-457-2486
Is Sole Proprietor?:No
Enumeration Date:2020-12-07
Last Update Date:2020-12-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY758348163W00000X
CARN95184956163WS0200X, 163WC1500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WC1500XNursing Service ProvidersRegistered NurseCommunity Health
No163W00000XNursing Service ProvidersRegistered Nurse
No163WS0200XNursing Service ProvidersRegistered NurseSchool