Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 363LF0000X | Nurse Practitioner - Family Medicine | RN 621331 | CA |
NPI | 1003113887 |
---|---|
Provider Name | Mrs. Sharlene Junio Madanes |
First Address | Santa Clara, CA 95051-5173 |
Second Address | Santa Clara, CA 95051-5173 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 14/02/2011 |
Last Update Date | 30/12/2021 |