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

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