Provider Demographics
NPI:1447832175
Name:ARANDA, MARY VIVIAN M (BSN RN)
Entity type:Individual
Prefix:
First Name:MARY VIVIAN
Middle Name:M
Last Name:ARANDA
Suffix:
Gender:F
Credentials:BSN RN
Other - Prefix:
Other - First Name:
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Mailing Address - Street 1:5508 CENTURY MANOR CT
Mailing Address - Street 2:
Mailing Address - City:SAN JOSE
Mailing Address - State:CA
Mailing Address - Zip Code:95111-1808
Mailing Address - Country:US
Mailing Address - Phone:408-416-8846
Mailing Address - Fax:
Practice Address - Street 1:5988 SILVER CREEK VALLEY RD STE 60
Practice Address - Street 2:
Practice Address - City:SAN JOSE
Practice Address - State:CA
Practice Address - Zip Code:95138-1077
Practice Address - Country:US
Practice Address - Phone:408-363-8900
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-04-22
Last Update Date:2021-04-22
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
CA637598163W00000X, 163WC0400X, 163WC2100X, 163WG0600X, 163WI0500X, 163WW0000X, 163WX1500X, 163WG0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WG0000XNursing Service ProvidersRegistered NurseGeneral Practice
No163W00000XNursing Service ProvidersRegistered Nurse
No163WC0400XNursing Service ProvidersRegistered NurseCase Management
No163WC2100XNursing Service ProvidersRegistered NurseContinence Care
No163WG0600XNursing Service ProvidersRegistered NurseGerontology
No163WI0500XNursing Service ProvidersRegistered NurseInfusion Therapy
No163WW0000XNursing Service ProvidersRegistered NurseWound Care
No163WX1500XNursing Service ProvidersRegistered NurseOstomy Care
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA1588704449OtherHMO MEDICARE ADVANTAGE