Provider Demographics
NPI:1669802401
Name:NYLAND, ALEECE
Entity type:Individual
Prefix:
First Name:ALEECE
Middle Name:
Last Name:NYLAND
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:ALEECE
Other - Middle Name:
Other - Last Name:JOHNSON
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:20800 HOMESTEAD RD # A
Mailing Address - Street 2:APT 10F
Mailing Address - City:CUPERTINO
Mailing Address - State:CA
Mailing Address - Zip Code:95014-0458
Mailing Address - Country:US
Mailing Address - Phone:408-207-7749
Mailing Address - Fax:
Practice Address - Street 1:232 E GISH RD
Practice Address - Street 2:
Practice Address - City:SAN JOSE
Practice Address - State:CA
Practice Address - Zip Code:95112-4706
Practice Address - Country:US
Practice Address - Phone:408-332-6048
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2013-11-14
Last Update Date:2013-11-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171M00000XOther Service ProvidersCase Manager/Care Coordinator