Healthcare Provider Details

I. General information

NPI: 1003386103
Provider Name (Legal Business Name): BRENDA ARMENTA
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 11/30/2018
Last Update Date: 08/21/2026
Certification Date: 08/21/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

10400 FRICOT CITY RD UNIT J
SAN ANDREAS CA
95249-9642
US

IV. Provider business mailing address

445 LEIGH AVE
LOS GATOS CA
95032-4000
US

V. Phone/Fax

Practice location:
  • Phone: 209-736-4500
  • Fax:
Mailing address:
  • Phone: 866-227-1211
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code171M00000X
TaxonomyCase Manager/Care Coordinator
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code174H00000X
TaxonomyHealth Educator
License Number
License Number State
# 3
Primary TaxonomyY
Taxonomy Code372600000X
TaxonomyAdult Companion
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: