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General NPI Number Information
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NPI Number | 1285424713
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Entity Type | Individual
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Provider Name | EDITH VILLA BRUNO
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Gender |
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Dates
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Enumeration Date | 05/08/2025
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Last Update Date | 05/08/2025
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Provider Practice Location Address
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Address Line | 3801 MIRANDA AVE
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City | PALO ALTO
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State | CA
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Zip | 94304-1207
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Country | US
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Telephone | 650-493-5000
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Fax |
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Provider Business Mailing Address
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Address Line | 349 STAPLES AVE
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City | SAN JOSE
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State | CA
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Zip | 95127-1559
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Country | US
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Telephone | 408-373-5621
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 163WW0000X
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Taxonomy Name | Wound Care Registered Nurse
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License Number | 95297744
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License Number State | CA
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