Healthcare Provider Details

I. General information

NPI: 1447832175
Provider Name (Legal Business Name): MARY VIVIAN M ARANDA BSN RN
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 04/22/2021
Last Update Date: 04/22/2021
Certification Date: 04/22/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5988 SILVER CREEK VALLEY RD STE 60
SAN JOSE CA
95138-1077
US

IV. Provider business mailing address

5508 CENTURY MANOR CT
SAN JOSE CA
95111-1808
US

V. Phone/Fax

Practice location:
  • Phone: 408-363-8900
  • Fax:
Mailing address:
  • Phone: 408-416-8846
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License Number637598
License Number StateCA
# 2
Primary TaxonomyN
Taxonomy Code163WC0400X
TaxonomyCase Management Registered Nurse
License Number637598
License Number StateCA
# 3
Primary TaxonomyN
Taxonomy Code163WC2100X
TaxonomyContinence Care Registered Nurse
License Number637598
License Number StateCA
# 4
Primary TaxonomyN
Taxonomy Code163WG0600X
TaxonomyGerontology Registered Nurse
License Number637598
License Number StateCA
# 5
Primary TaxonomyN
Taxonomy Code163WI0500X
TaxonomyInfusion Therapy Registered Nurse
License Number637598
License Number StateCA
# 6
Primary TaxonomyN
Taxonomy Code163WW0000X
TaxonomyWound Care Registered Nurse
License Number637598
License Number StateCA
# 7
Primary TaxonomyN
Taxonomy Code163WX1500X
TaxonomyOstomy Care Registered Nurse
License Number637598
License Number StateCA
# 8
Primary TaxonomyY
Taxonomy Code163WG0000X
TaxonomyGeneral Practice Registered Nurse
License Number637598
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: