Provider Demographics
NPI:1053819961
Name:ROMIS, GERALDIN (NP-C, RN, PA-C)
Entity Type:Individual
Prefix:MS
First Name:GERALDIN
Middle Name:
Last Name:ROMIS
Suffix:
Gender:F
Credentials:NP-C, RN, PA-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2539 GLEN KEW CT
Mailing Address - Street 2:
Mailing Address - City:SAN JOSE
Mailing Address - State:CA
Mailing Address - Zip Code:95148-4131
Mailing Address - Country:US
Mailing Address - Phone:408-603-6554
Mailing Address - Fax:
Practice Address - Street 1:2539 GLEN KEW CT
Practice Address - Street 2:
Practice Address - City:SAN JOSE
Practice Address - State:CA
Practice Address - Zip Code:95148-4131
Practice Address - Country:US
Practice Address - Phone:408-603-6554
Practice Address - Fax:408-603-6554
Is Sole Proprietor?:Yes
Enumeration Date:2018-01-25
Last Update Date:2018-01-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA818501163W00000X
CA95008217363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
No163W00000XNursing Service ProvidersRegistered Nurse