Basic Information
| Provider Information | |||||||||
| NPI: | 1427307651 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | OGAMBA | ||||||||
| FirstName: | VALENTINE | ||||||||
| MiddleName: | OSITA | ||||||||
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| Credential: | NURSE | ||||||||
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| Mailing Information | |||||||||
| Address1: | 456 FONICK DR | ||||||||
| Address2: | |||||||||
| City: | SAN JOSE | ||||||||
| State: | CA | ||||||||
| PostalCode: | 951111717 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 4088364041 | ||||||||
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| Practice Location | |||||||||
| Address1: | 2001 THE ALAMEDA | ||||||||
| Address2: | |||||||||
| City: | SAN JOSE | ||||||||
| State: | CA | ||||||||
| PostalCode: | 951261136 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 4082617777 | ||||||||
| FaxNumber: | 4082549960 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 09/04/2012 | ||||||||
| LastUpdateDate: | 04/02/2014 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 164X00000X | VN259729 | CA | Y | Nursing Service Providers | Licensed Vocational Nurse | 103K00000X | VN259729 | CA | N | Behavioral Health & Social Service Providers | Behavioral Analyst |
No ID Information.