Healthcare Provider Details

I. General information

NPI: 1245003904
Provider Name (Legal Business Name): JULIA CARACENI CORRADO
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 11/03/2023
Last Update Date: 03/14/2025
Certification Date: 03/14/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2880 STORY RD FL 2
SAN JOSE CA
95127-3942
US

IV. Provider business mailing address

PO BOX 2435
SANTA CLARA CA
95055-2435
US

V. Phone/Fax

Practice location:
  • Phone: 408-929-5439
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number95027946
License Number StateCA
# 2
Primary TaxonomyN
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License Number95250368
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: