Healthcare Provider Details

I. General information

NPI: 1679161335
Provider Name (Legal Business Name): ROCHELLE POPYON
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 01/07/2021
Last Update Date: 01/07/2021
Certification Date: 01/07/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

160 E VIRGINIA ST STE 100
SAN JOSE CA
95112-5865
US

IV. Provider business mailing address

160 E VIRGINIA ST STE 100
SAN JOSE CA
95112-5865
US

V. Phone/Fax

Practice location:
  • Phone: 408-579-6178
  • Fax: 408-579-6143
Mailing address:
  • Phone: 408-579-6178
  • Fax: 408-579-6143

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number95006932
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: