Healthcare Provider Details
I. General information
NPI: 1780878488
Provider Name (Legal Business Name): SYLVIA PATIENCE N.P.
Entity Type: Individual
Gender: Female
Sole Proprietor: N
II. Dates (important events)
Enumeration Date: 09/05/2007
Last Update Date: 09/05/2007
Certification Date:
Deactivation Date:
Reactivation Date:
III. Provider practice location address
1149 E JULIAN ST BLDG H
SAN JOSE CA
95116-1005
US
IV. Provider business mailing address
5671 SANTA TERESA BLVD STE 105
SAN JOSE CA
95123-6512
US
V. Phone/Fax
- Phone: 408-535-6001
- Fax: 408-535-2348
- Phone: 408-284-2281
- Fax: 408-281-2857
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 363LF0000X |
| Taxonomy | Family Nurse Practitioner |
| License Number | 236190 |
| License Number State | CA |
VIII. Authorized Official
Name:
Title or Position:
Credential:
Phone: