Healthcare Provider Details

I. General information

NPI: 1255150793
Provider Name (Legal Business Name): MARI ESTELA SIGRID GACHO RN
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 10/10/2024
Last Update Date: 10/10/2024
Certification Date: 10/10/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3801 MIRANDA AVE
PALO ALTO CA
94304-1207
US

IV. Provider business mailing address

1571 W EL CAMINO REAL APT 16
MOUNTAIN VIEW CA
94040-2443
US

V. Phone/Fax

Practice location:
  • Phone: 650-493-5000
  • Fax:
Mailing address:
  • Phone: 786-281-0811
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163WP2201X
TaxonomyAmbulatory Care Registered Nurse
License Number775360
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: