Healthcare Provider Details

I. General information

NPI: 1356268130
Provider Name (Legal Business Name): MELISA ESCARCEGA KIKU MELISA ESCARCEGA
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/01/2026
Last Update Date: 07/01/2026
Certification Date: 07/01/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1460 THE ALAMEDA
SAN JOSE CA
95126-2652
US

IV. Provider business mailing address

1290 RIDDER PARK DR
SAN JOSE CA
95131-2304
US

V. Phone/Fax

Practice location:
  • Phone: 408-535-6235
  • Fax:
Mailing address:
  • Phone: 408-453-6500
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225XP0200X
TaxonomyPediatric Occupational Therapist
License Number6956
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: