Provider Demographics
NPI:1013749696
Name:DIAS-ALCOBER, MICHELE MICHIKO TANAKA (RRT, RCP)
Entity type:Individual
Prefix:
First Name:MICHELE
Middle Name:MICHIKO TANAKA
Last Name:DIAS-ALCOBER
Suffix:
Gender:F
Credentials:RRT, RCP
Other - Prefix:
Other - First Name:MICHELE
Other - Middle Name:MICHIKO TANAKA
Other - Last Name:DIAS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:RRT, RCP
Mailing Address - Street 1:4426 FENICO TER
Mailing Address - Street 2:
Mailing Address - City:FREMONT
Mailing Address - State:CA
Mailing Address - Zip Code:94536-5627
Mailing Address - Country:US
Mailing Address - Phone:510-996-2200
Mailing Address - Fax:
Practice Address - Street 1:3801 MIRANDA AVE BLDG 1
Practice Address - Street 2:
Practice Address - City:PALO ALTO
Practice Address - State:CA
Practice Address - Zip Code:94304-1207
Practice Address - Country:US
Practice Address - Phone:650-493-5000
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-08-14
Last Update Date:2024-08-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA41121227800000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes227800000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersRespiratory Therapist, Certified