Healthcare Provider Details

I. General information

NPI: 1649614074
Provider Name (Legal Business Name): NORMA ELENA VINDELL
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/29/2013
Last Update Date: 04/29/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

777 N 1ST ST STE 444
SAN JOSE CA
95112-6339
US

IV. Provider business mailing address

777 N 1ST ST STE 444
SAN JOSE CA
95112-6339
US

V. Phone/Fax

Practice location:
  • Phone: 408-240-0070
  • Fax: 408-240-0077
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101Y00000X
TaxonomyCounselor
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: