Healthcare Provider Details

I. General information

NPI: 1881139756
Provider Name (Legal Business Name): MEYLIEN DARLENE HAN BSC
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 12/30/2016
Last Update Date: 03/29/2017
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1400 PARKMOOR AVE
SAN JOSE CA
95126-3797
US

IV. Provider business mailing address

1030 S 12TH ST APT D3
SAN JOSE CA
95112-2458
US

V. Phone/Fax

Practice location:
  • Phone: 408-510-3480
  • Fax:
Mailing address:
  • Phone: 408-645-9539
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code101Y00000X
TaxonomyCounselor
License Number
License Number StateCA
# 2
Primary TaxonomyY
Taxonomy Code171M00000X
TaxonomyCase Manager/Care Coordinator
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: