Provider Demographics
NPI:1306688890
Name:D'SOUZA, JANE
Entity type:Individual
Prefix:
First Name:JANE
Middle Name:
Last Name:D'SOUZA
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 1:100 S MURPHY AVE STE 111
Mailing Address - Street 2:
Mailing Address - City:SUNNYVALE
Mailing Address - State:CA
Mailing Address - Zip Code:94086-6118
Mailing Address - Country:US
Mailing Address - Phone:669-221-1720
Mailing Address - Fax:
Practice Address - Street 1:100 S MURPHY AVE STE 111
Practice Address - Street 2:
Practice Address - City:SUNNYVALE
Practice Address - State:CA
Practice Address - Zip Code:94086-6118
Practice Address - Country:US
Practice Address - Phone:669-221-1720
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-06-07
Last Update Date:2024-06-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA171400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171400000XOther Service ProvidersHealth & Wellness Coach