Provider Demographics
NPI:1831222496
Name:HIRANO, CAROLYN BERNADETTE (MSN, FNP)
Entity type:Individual
Prefix:
First Name:CAROLYN
Middle Name:BERNADETTE
Last Name:HIRANO
Suffix:
Gender:F
Credentials:MSN, FNP
Other - Prefix:
Other - First Name:CAROLYN
Other - Middle Name:BERNADETTE
Other - Last Name:MAHONEY
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MSN, FNP
Mailing Address - Street 1:15047 LOS GATOS BLVD
Mailing Address - Street 2:STE 200
Mailing Address - City:LOS GATOS
Mailing Address - State:CA
Mailing Address - Zip Code:95032-2054
Mailing Address - Country:US
Mailing Address - Phone:408-364-6799
Mailing Address - Fax:408-378-4510
Practice Address - Street 1:15047 LOS GATOS BLVD
Practice Address - Street 2:STE 200
Practice Address - City:LOS GATOS
Practice Address - State:CA
Practice Address - Zip Code:95032-2054
Practice Address - Country:US
Practice Address - Phone:408-364-6799
Practice Address - Fax:408-378-4510
Is Sole Proprietor?:No
Enumeration Date:2007-03-13
Last Update Date:2009-01-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CANPF16005163WP0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WP0000XNursing Service ProvidersRegistered NursePain Management
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAQ58529Medicare UPIN