Individual
MS. MARIA CHARISMA SIDECO LICERALDE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
APRN, PMHNP, BC
Contact information
Practice address
80 GREAT OAKS BLVD, SAN JOSE, CA 95119-1310
(408) 363-3000
(408) 363-3046
Mailing address
80 GREAT OAKS BLVD, SAN JOSE, CA 95119-1310
(408) 363-3000
(408) 363-3046
Taxonomy
Speciality
Code
Description
License number
State
163WP0809X
Adult Psychiatric/Mental Health Registered Nurse
Primary
715901
CA
Other
Enumeration date
02/07/2008
Last updated
02/07/2008
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