Provider Demographics
NPI:1346887841
Name:MARCHESE, NICHOLE L
Entity Type:Individual
Prefix:
First Name:NICHOLE
Middle Name:L
Last Name:MARCHESE
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 1:800 N 1ST ST
Mailing Address - Street 2:
Mailing Address - City:SAN JOSE
Mailing Address - State:CA
Mailing Address - Zip Code:95112-6312
Mailing Address - Country:US
Mailing Address - Phone:669-245-3429
Mailing Address - Fax:408-550-7433
Practice Address - Street 1:800 N 1ST ST
Practice Address - Street 2:
Practice Address - City:SAN JOSE
Practice Address - State:CA
Practice Address - Zip Code:95112-6312
Practice Address - Country:US
Practice Address - Phone:669-245-3429
Practice Address - Fax:408-550-7433
Is Sole Proprietor?:Yes
Enumeration Date:2019-12-03
Last Update Date:2019-12-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171M00000XOther Service ProvidersCase Manager/Care Coordinator