Healthcare Provider Details

I. General information

NPI: 1952585416
Provider Name (Legal Business Name): DR. KRISTIE JAGHAB TREFTZ
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 12/19/2007
Last Update Date: 06/06/2025
Certification Date: 06/06/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1888 MERIDIAN AVE SUITE 150
SAN JOSE CA
95125
US

IV. Provider business mailing address

1333 MERIDIAN AVE
SAN JOSE CA
95125-5212
US

V. Phone/Fax

Practice location:
  • Phone: 408-445-8172
  • Fax: 408-266-6614
Mailing address:
  • Phone: 408-445-3400
  • Fax: 408-350-2411

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103T00000X
TaxonomyPsychologist
License NumberPSY21655
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: