Provider Demographics
NPI:1245911205
Name:BYRD, FAITH ELENA (PARA PROFESSIONAL)
Entity type:Individual
Prefix:
First Name:FAITH
Middle Name:ELENA
Last Name:BYRD
Suffix:
Gender:F
Credentials:PARA PROFESSIONAL
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:90 GREAT OAKS BLVD STE 108
Mailing Address - Street 2:
Mailing Address - City:SAN JOSE
Mailing Address - State:CA
Mailing Address - Zip Code:95119-1314
Mailing Address - Country:US
Mailing Address - Phone:831-212-0739
Mailing Address - Fax:
Practice Address - Street 1:90 GREAT OAKS BLVD STE 108
Practice Address - Street 2:
Practice Address - City:SAN JOSE
Practice Address - State:CA
Practice Address - Zip Code:95119-1314
Practice Address - Country:US
Practice Address - Phone:831-212-0739
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-07-31
Last Update Date:2023-08-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171M00000XOther Service ProvidersCase Manager/Care Coordinator
No146D00000XEmergency Medical Service ProvidersPersonal Emergency Response Attendant