Individual
ELLEN PEREZ TRAVIS
Active
Sole proprietor
Provider details
NPI number
Gender
F
Credential
NP
Contact information
Practice address
751 S BASCOM AVE, SAN JOSE, CA 95128-2604
(408) 885-6780
Mailing address
542 VALLEY FORGE WAY, CAMPBELL, CA 95008-0547
(408) 793-6771
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
418417-9309
CA
Other
Enumeration date
07/13/2005
Last updated
03/07/2023
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