Provider Demographics
NPI:1205602315
Name:SAYSON, IRENE LARAYA (NURSE PRACTITIONER)
Entity type:Individual
Prefix:
First Name:IRENE
Middle Name:LARAYA
Last Name:SAYSON
Suffix:
Gender:F
Credentials:NURSE PRACTITIONER
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4514 ARCE ST
Mailing Address - Street 2:
Mailing Address - City:UNION CITY
Mailing Address - State:CA
Mailing Address - Zip Code:94587-5640
Mailing Address - Country:US
Mailing Address - Phone:650-400-6323
Mailing Address - Fax:
Practice Address - Street 1:19600 VALLCO PKWY STE 170
Practice Address - Street 2:
Practice Address - City:CUPERTINO
Practice Address - State:CA
Practice Address - Zip Code:95014-7136
Practice Address - Country:US
Practice Address - Phone:650-400-6323
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-11-29
Last Update Date:2023-11-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA95027519363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily