Provider Demographics
NPI:1659001337
Name:LE, THAO THI VIET (RN952807733)
Entity Type:Individual
Prefix:
First Name:THAO
Middle Name:THI VIET
Last Name:LE
Suffix:
Gender:F
Credentials:RN952807733
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2183 ROCKROSE CT
Mailing Address - Street 2:
Mailing Address - City:SAN JOSE
Mailing Address - State:CA
Mailing Address - Zip Code:95133-1282
Mailing Address - Country:US
Mailing Address - Phone:408-963-7116
Mailing Address - Fax:
Practice Address - Street 1:2183 ROCKROSE CT
Practice Address - Street 2:
Practice Address - City:SAN JOSE
Practice Address - State:CA
Practice Address - Zip Code:95133-1282
Practice Address - Country:US
Practice Address - Phone:408-963-7116
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-06-15
Last Update Date:2022-06-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CARN95280733163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse