Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
NPIDirectory

Eloisa B Dietrich

Individual provider Family Nurse Practitioner · NPI 1134512288

Eloisa B Dietrich is a Nurse Practitioner in San Marcos, California. Qualified in 2012, 14 years ago. Practices with Mark David Levine MD Professional Corporation, a 157-clinician group, works from 2 locations, accepts Medicare assignment and offers telehealth. Licensed in California.

Years since qualifying
14
Licensed in
CA
In the registry since
2015
Specialties on file
2
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Practice location Address checks out

277 Rancheros Dr Ste 301
San Marcos, CA 92069-2993
Phone: (760) 471-4073
Fax: (760) 471-4078
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Additional practice locations (1)

  • 425 Diamond Dr Ste 104, Lake Elsinore, CA 92530-4495 — (516) 744-1149

Specialties & licences

Psychiatric/Mental Health Nurse Practitioner (primary) Taxonomy 363LP0808X · Licence 363LFOOOOX (CA)
Family Nurse Practitioner Taxonomy 363LF0000X · Licence 95001871 (CA)

Record details

NPI number1134512288
Entity typeIndividual (Type 1)
GenderFemale
Sole proprietorNo
NPI enumeratedMarch 13, 2015
Last updated in NPPESMay 24, 2024
Certification dateMay 24, 2024
Mailing address3835 N Freeway Blvd Ste 100, Sacramento, CA 95834-1954

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyNURSE PRACTITIONER
Medical schoolOTHER
Graduated 2012 (14 years in practice)
Group practice Mark David Levine Md Professional Corporation — 157 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount
TelehealthOffers telehealth services

Other providers in San Marcos