Healthcare Provider Details

I. General information

NPI: 1659987642
Provider Name (Legal Business Name): JULIANA DUZ RICARTE COVARRUBIAS
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 09/16/2020
Last Update Date: 08/15/2025
Certification Date: 08/15/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

114 ROYCE ST STE E
LOS GATOS CA
95030-6041
US

IV. Provider business mailing address

15025 DOWNING OAK CT APT 1
LOS GATOS CA
95032-3925
US

V. Phone/Fax

Practice location:
  • Phone: 408-358-1459
  • Fax:
Mailing address:
  • Phone: 310-699-5041
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225X00000X
TaxonomyOccupational Therapist
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: