Healthcare Provider Details

I. General information

NPI: 1982948295
Provider Name (Legal Business Name): JOSE ROBERT K GATICALES APN
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 11/27/2012
Last Update Date: 10/16/2025
Certification Date: 10/16/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

325 GELLERT BLVD
DALY CITY CA
94015-2613
US

IV. Provider business mailing address

1375 BLOSSOM HILL RD STE 49
SAN JOSE CA
95118-3806
US

V. Phone/Fax

Practice location:
  • Phone: 650-270-2394
  • Fax:
Mailing address:
  • Phone: 408-645-7073
  • Fax: 669-500-7491

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License NumberAPRN001451
License Number StateNV
# 2
Primary TaxonomyN
Taxonomy Code363LP2300X
TaxonomyPrimary Care Nurse Practitioner
License NumberAPN001451
License Number StateNV
# 3
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberNP95029525
License Number StateCA
# 4
Primary TaxonomyN
Taxonomy Code207RI0200X
TaxonomyInfectious Disease Physician
License NumberAPN001451
License Number StateNV
# 5
Primary TaxonomyN
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberAP61332499
License Number StateWA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: