Provider Demographics
NPI:1902151509
Name:FELDMAN, CHARISSE (RN, BSN, PHN)
Entity Type:Individual
Prefix:
First Name:CHARISSE
Middle Name:
Last Name:FELDMAN
Suffix:
Gender:F
Credentials:RN, BSN, PHN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1993 MCKEE RD
Mailing Address - Street 2:BUILDING B
Mailing Address - City:SAN JOSE
Mailing Address - State:CA
Mailing Address - Zip Code:95116-1406
Mailing Address - Country:US
Mailing Address - Phone:408-937-2238
Mailing Address - Fax:408-937-2232
Practice Address - Street 1:1993 MCKEE RD
Practice Address - Street 2:BUILDING B
Practice Address - City:SAN JOSE
Practice Address - State:CA
Practice Address - Zip Code:95116-1406
Practice Address - Country:US
Practice Address - Phone:408-937-2238
Practice Address - Fax:408-937-2232
Is Sole Proprietor?:No
Enumeration Date:2012-07-19
Last Update Date:2012-07-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA514173163WC0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WC0400XNursing Service ProvidersRegistered NurseCase Management