Healthcare Provider Details

I. General information

NPI: 1982245007
Provider Name (Legal Business Name): MRS. YANEX ELIZABETH ORELLANA
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/30/2019
Last Update Date: 11/01/2023
Certification Date: 11/01/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5855 SILVER CREEK VALLEY RD # NH3
SAN JOSE CA
95138-1059
US

IV. Provider business mailing address

5855 SILVER CREEK VALLEY RD
SAN JOSE CA
95138-1059
US

V. Phone/Fax

Practice location:
  • Phone: 408-574-9254
  • Fax:
Mailing address:
  • Phone: 408-574-9254
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number118651
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: