Healthcare Provider Details

I. General information

NPI: 1487938841
Provider Name (Legal Business Name): CHRISTINE S NIEH
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/04/2011
Last Update Date: 09/11/2026
Certification Date: 09/11/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

645 WOOL CREEK DR
SAN JOSE CA
95112-2617
US

IV. Provider business mailing address

3975 MIRA LOMA WAY
SAN JOSE CA
95111-3520
US

V. Phone/Fax

Practice location:
  • Phone: 408-283-6000
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code235Z00000X
TaxonomySpeech-Language Pathologist
License Number20162
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: