Provider Demographics
NPI:1245423144
Name:VANDERWERF, PURIFICACION LEUTERIO
Entity Type:Individual
Prefix:MRS
First Name:PURIFICACION
Middle Name:LEUTERIO
Last Name:VANDERWERF
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1305 SUNRISE WAY
Mailing Address - Street 2:
Mailing Address - City:MILPITAS
Mailing Address - State:CA
Mailing Address - Zip Code:95035-6241
Mailing Address - Country:US
Mailing Address - Phone:408-717-1080
Mailing Address - Fax:
Practice Address - Street 1:1305 SUNRISE WAY
Practice Address - Street 2:
Practice Address - City:MILPITAS
Practice Address - State:CA
Practice Address - Zip Code:95035-6241
Practice Address - Country:US
Practice Address - Phone:408-717-1080
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-08-23
Last Update Date:2007-08-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA374U00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374U00000XNursing Service Related ProvidersHome Health Aide