Provider Demographics
NPI:1578907473
Name:VALDERRAMA, KAREN
Entity Type:Individual
Prefix:
First Name:KAREN
Middle Name:
Last Name:VALDERRAMA
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:PO BOX 3342
Mailing Address - Street 2:
Mailing Address - City:SAN JOSE
Mailing Address - State:CA
Mailing Address - Zip Code:95156-3342
Mailing Address - Country:US
Mailing Address - Phone:408-202-2492
Mailing Address - Fax:
Practice Address - Street 1:3271 BRUNO DR
Practice Address - Street 2:
Practice Address - City:SAN JOSE
Practice Address - State:CA
Practice Address - Zip Code:95136-3941
Practice Address - Country:US
Practice Address - Phone:408-202-2492
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2013-04-22
Last Update Date:2013-04-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes172V00000XOther Service ProvidersCommunity Health Worker