MEDICARE: VANESSA MAE BALCAZAR

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	163W00000X	Registered Nurse	95057290	CA

General Provider Information

NPI Number	:	1679424626
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	VANESSA MAE BALCAZAR

Provider Business Mailing Address
First Line	:	15400 CALLE ENRIQUE
Second Line	:
City	:	MORGAN HILL
State	:	CA
Zip	:	95037-5614
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	710 LAWRENCE EXPY
Second Line	:
City	:	SANTA CLARA
State	:	CA
Zip	:	95051-5173
Country	:	US
Telephone Number	:	408-851-3709
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	02/05/2026
Last Update Date	:	02/05/2026

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