Healthcare Provider Details

I. General information

NPI: 1053250340
Provider Name (Legal Business Name): VALERIA MICHALLE CAMPOS ROBLES
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 03/25/2026
Last Update Date: 03/25/2026
Certification Date: 03/25/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

22400 CARROLL OAKS WAY
SAN JOSE CA
95120-3721
US

IV. Provider business mailing address

22400 CARROLL OAKS WAY
SAN JOSE CA
95120-3721
US

V. Phone/Fax

Practice location:
  • Phone: 408-660-5414
  • Fax: 885-461-3499
Mailing address:
  • Phone: 408-660-5414
  • Fax: 885-461-3499

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code106S00000X
TaxonomyBehavior Technician
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: