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NPI Code Detail

MEDICARE: ARLEEN STA. MARIA COMISO FNP-C

MEDICARE: ARLEEN STA. MARIA COMISO FNP-C
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
1363LF0000XFamily Nurse Practitioner22880CA
2363LP2300XPrimary Care Nurse Practitioner22880CA

General Provider Information

NPI Number : 1811337470
Entity Type Code : Individual
Provider Name (Legal Business Name) : ARLEEN STA. MARIA COMISO FNP-C
Provider Business Mailing Address
First Line : 2514 BERRYESSA RD
Second Line :
City : SAN JOSE
State : CA
Zip : 95132-2947
Country : US
Telephone Number : 408-272-1432
Fax Number : 408-926-6142
Provider Business Practice Location Address
First Line : 2514 BERRYESSA RD
Second Line :
City : SAN JOSE
State : CA
Zip : 95132-2947
Country : US
Telephone Number : 408-272-1432
Fax Number : 408-926-6142
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/27/2013
Last Update Date : 04/05/2016

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Directions to “ ARLEEN STA. MARIA COMISO FNP-C” Practice Location

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