Healthcare Provider Details

I. General information

NPI: 1508663097
Provider Name (Legal Business Name): DEVORA PINSKY
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/03/2025
Last Update Date: 03/03/2025
Certification Date: 03/03/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1 WASHINGTON SQUARE
SAN JOSE CA
95192-1000
US

IV. Provider business mailing address

1670 LINCOLN AVE
SAN JOSE CA
95125-3353
US

V. Phone/Fax

Practice location:
  • Phone: 617-894-6102
  • Fax:
Mailing address:
  • Phone: 617-894-6102
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163WC1400X
TaxonomyCollege Health Registered Nurse
License Number95329411
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: