Provider Demographics
NPI:1457426249
Name:DELVIGNA, CONSTANCE MAE (RN)
Entity Type:Individual
Prefix:MRS
First Name:CONSTANCE
Middle Name:MAE
Last Name:DELVIGNA
Suffix:
Gender:F
Credentials:RN
Other - Prefix:MISS
Other - First Name:CONSTANCE
Other - Middle Name:MAE
Other - Last Name:RYLEE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:RN, LPN
Mailing Address - Street 1:1691 THE ALAMEDA
Mailing Address - Street 2:
Mailing Address - City:SAN JOSE
Mailing Address - State:CA
Mailing Address - Zip Code:95126-2203
Mailing Address - Country:US
Mailing Address - Phone:408-287-7532
Mailing Address - Fax:408-287-0405
Practice Address - Street 1:1691 THE ALAMEDA
Practice Address - Street 2:
Practice Address - City:SAN JOSE
Practice Address - State:CA
Practice Address - Zip Code:95126-2203
Practice Address - Country:US
Practice Address - Phone:408-287-7529
Practice Address - Fax:408-971-6963
Is Sole Proprietor?:No
Enumeration Date:2006-11-21
Last Update Date:2007-07-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CARN353468163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse