Nakkerud-Whiteside, Brian James

Nakkerud-Whiteside, Brian James is an individual health care provider with primary practice located at 1400 Emeline Ave , Santa Cruz CA 95060-1976. He recently has 2 registered licenses in different health care specialties including Nursing Service Providers / Registered Nurse, Physician Assistants & Advanced Practice Nursing Providers / Psychiatric/Mental Health. Physician Assistants & Advanced Practice Nursing Providers / Psychiatric/Mental Health is his primary health care specialty. Nakkerud-Whiteside, Brian James can be contacted via phone (831) 454-4170.

Contact Information

Primary practice address
1400 Emeline Ave Santa Cruz CA 95060-1976
Phone: (831) 454-4170
Fax: (831) 454-4663
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Nursing Service Providers / Registered Nurse 163W00000X 802020 California
Physician Assistants & Advanced Practice Nursing Providers / Psychiatric/Mental Health 363LP0808X 87055 California
Physician Assistants & Advanced Practice Nursing Providers / Psychiatric/Mental Health 363LP0808X 23511 California

Profile Details

NPI number 1417205527
LBN Legal business name Nakkerud-Whiteside, Brian James
Credentials RN, PMHFNPC
Entity Individual
Sole proprietor 1 No
Enumeration date Aug 21st, 2012
Last updated May 11th, 2017 - about 8 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1417205527 NPPES
California Other ZZZ91891Z SANTA CRUZ COUNTY MEDICARE GROUP PTAN#
California Other FHC70042F SANTA CRUZ COUNTY MEDICARE GROUP PTAN#
California Other ZZZ92069Z SANTA CRUZ COUNTY MEDICARE GROUP PTAN#
California Other FHC70044F SANTA CRUZ COUNTY MEDICARE GROUP PTAN#
California Other ZZZ91892Z SANTA CRUZ COUNTY MEDICARE GROUP PTAN#

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