Healthcare Provider Details

I. General information

NPI: 1184947269
Provider Name (Legal Business Name): ELISABETH NAVARRO
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: ELISABETH FRANCO

II. Dates (important events)

Enumeration Date: 03/03/2010
Last Update Date: 03/03/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

144 N 32ND ST
SAN JOSE CA
95116-1208
US

IV. Provider business mailing address

144 N 32ND ST
SAN JOSE CA
95116-1208
US

V. Phone/Fax

Practice location:
  • Phone: 209-688-8102
  • Fax:
Mailing address:
  • Phone: 209-688-8102
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code247200000X
TaxonomyOther Technician
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: