Provider Demographics
NPI:1427877943
Name:NISHAN, PATRICIA XOCHITL
Entity type:Individual
Prefix:
First Name:PATRICIA
Middle Name:XOCHITL
Last Name:NISHAN
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:PATRICIA
Other - Middle Name:XOCHITL
Other - Last Name:QUEVEDO
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:2007 W HEDDING ST STE 201
Mailing Address - Street 2:
Mailing Address - City:SAN JOSE
Mailing Address - State:CA
Mailing Address - Zip Code:95128-1428
Mailing Address - Country:US
Mailing Address - Phone:866-375-2437
Mailing Address - Fax:
Practice Address - Street 1:910 CAMPISI WAY STE A1
Practice Address - Street 2:
Practice Address - City:CAMPBELL
Practice Address - State:CA
Practice Address - Zip Code:95008-2350
Practice Address - Country:US
Practice Address - Phone:408-826-8220
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-10-10
Last Update Date:2024-10-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA1-20-42277103K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst