Healthcare Provider Details

I. General information

NPI: 1528955234
Provider Name (Legal Business Name): STARLENE MARIE ESCARENO
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/24/2025
Last Update Date: 06/24/2025
Certification Date: 06/23/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1356 RIDDER PARK DR
SAN JOSE CA
95131-2313
US

IV. Provider business mailing address

9015 MURRAY AVE STE 100
GILROY CA
95020-3675
US

V. Phone/Fax

Practice location:
  • Phone: 408-990-5018
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225400000X
TaxonomyRehabilitation Practitioner
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: