Healthcare Provider Details

I. General information

NPI: 1710783410
Provider Name (Legal Business Name): FRISHA FAY REYES ELVINA RRT
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: FRISHA FAY REYES RRT

II. Dates (important events)

Enumeration Date: 02/22/2025
Last Update Date: 02/22/2025
Certification Date: 02/22/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

225 N JACKSON AVE
SAN JOSE CA
95116-1603
US

IV. Provider business mailing address

4259 SOLAR CIR
UNION CITY CA
94587-4044
US

V. Phone/Fax

Practice location:
  • Phone: 408-259-5000
  • Fax:
Mailing address:
  • Phone: 510-258-1157
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code227900000X
TaxonomyRegistered Respiratory Therapist
License Number30345
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: