Healthcare Provider Details

I. General information

NPI: 1407782444
Provider Name (Legal Business Name): MARIA ELOISA DABU
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/18/2026
Last Update Date: 06/18/2026
Certification Date: 06/18/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

550 GRIDLEY ST # MC323
SAN JOSE CA
95127-1540
US

IV. Provider business mailing address

1290 RIDDER PARK DR
SAN JOSE CA
95131-2304
US

V. Phone/Fax

Practice location:
  • Phone: 408-392-3980
  • Fax:
Mailing address:
  • Phone: 408-453-6500
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225X00000X
TaxonomyOccupational Therapist
License Number10158
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: