Provider Demographics
NPI:1326184300
Name:ROCCOSALVA, JANE A (OTC)
Entity Type:Individual
Prefix:
First Name:JANE
Middle Name:A
Last Name:ROCCOSALVA
Suffix:
Gender:F
Credentials:OTC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:732 PRITCHARD CT
Mailing Address - Street 2:
Mailing Address - City:SANTA CLARA
Mailing Address - State:CA
Mailing Address - Zip Code:95051-5715
Mailing Address - Country:US
Mailing Address - Phone:408-871-7272
Mailing Address - Fax:408-871-7268
Practice Address - Street 1:800 POLLARD RD STE A6
Practice Address - Street 2:
Practice Address - City:LOS GATOS
Practice Address - State:CA
Practice Address - Zip Code:95032-1432
Practice Address - Country:US
Practice Address - Phone:408-871-7272
Practice Address - Fax:408-871-7268
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-29
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA0631246Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes246Z00000XTechnologists, Technicians & Other Technical Service ProvidersSpecialist/Technologist, Other