Provider Demographics
NPI:1871109298
Name:OROZCO DE LA CRUZ, VANESA
Entity type:Individual
Prefix:
First Name:VANESA
Middle Name:
Last Name:OROZCO DE LA CRUZ
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:331 N 1ST ST APT 3
Mailing Address - Street 2:
Mailing Address - City:CAMPBELL
Mailing Address - State:CA
Mailing Address - Zip Code:95008-1327
Mailing Address - Country:US
Mailing Address - Phone:408-914-0782
Mailing Address - Fax:
Practice Address - Street 1:1171 HOMESTEAD RD
Practice Address - Street 2:
Practice Address - City:SANTA CLARA
Practice Address - State:CA
Practice Address - Zip Code:95050-5478
Practice Address - Country:US
Practice Address - Phone:872-469-7104
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-09-21
Last Update Date:2020-09-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician