Healthcare Provider Details

I. General information

NPI: 1609721349
Provider Name (Legal Business Name): RITA ANZUALDA MPSS-BSFJPW
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 02/27/2026
Last Update Date: 02/27/2026
Certification Date: 02/27/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

16433 MONTEREY RD STE 140
MORGAN HILL CA
95037-7168
US

IV. Provider business mailing address

7370 CHURCH ST APT B
GILROY CA
95020-6165
US

V. Phone/Fax

Practice location:
  • Phone: 408-782-6300
  • Fax:
Mailing address:
  • Phone: 408-430-4426
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code175T00000X
TaxonomyPeer Specialist
License NumberMPSS-BSFJPW
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: