Provider Demographics
NPI:1427087790
Name:STOREY, EMILY Z (NP)
Entity type:Individual
Prefix:MRS
First Name:EMILY
Middle Name:Z
Last Name:STOREY
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:EMILY
Other - Middle Name:Z
Other - Last Name:WALSH
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:NP
Mailing Address - Street 1:900 BLAKE WILBUR DR.
Mailing Address - Street 2:
Mailing Address - City:STANFORD
Mailing Address - State:CA
Mailing Address - Zip Code:94305
Mailing Address - Country:US
Mailing Address - Phone:650-498-6004
Mailing Address - Fax:
Practice Address - Street 1:900 BLAKE WILBUR DR.
Practice Address - Street 2:
Practice Address - City:STANFORD
Practice Address - State:CA
Practice Address - Zip Code:94305
Practice Address - Country:US
Practice Address - Phone:650-498-6004
Practice Address - Fax:650-723-4000
Is Sole Proprietor?:No
Enumeration Date:2006-06-30
Last Update Date:2018-04-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA14921363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA00149210Medicaid
CA00149210Medicaid