Provider Demographics
NPI:1982948295
Name:GATICALES, JOSE ROBERT K (APN)
Entity type:Individual
Prefix:
First Name:JOSE ROBERT
Middle Name:K
Last Name:GATICALES
Suffix:
Gender:
Credentials:APN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:1375 BLOSSOM HILL RD STE 49
Mailing Address - Street 2:
Mailing Address - City:SAN JOSE
Mailing Address - State:CA
Mailing Address - Zip Code:95118-3806
Mailing Address - Country:US
Mailing Address - Phone:408-645-7073
Mailing Address - Fax:669-500-7491
Practice Address - Street 1:1375 BLOSSOM HILL RD STE 49
Practice Address - Street 2:
Practice Address - City:SAN JOSE
Practice Address - State:CA
Practice Address - Zip Code:95118-3806
Practice Address - Country:US
Practice Address - Phone:408-645-7073
Practice Address - Fax:669-500-7491
Is Sole Proprietor?:No
Enumeration Date:2012-11-27
Last Update Date:2025-03-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NVAPN001451207RI0200X, 363LP2300X
NVAPRN001451363L00000X
WAAP61332499363LF0000X
CA796464363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
No207RI0200XAllopathic & Osteopathic PhysiciansInternal MedicineInfectious Disease
No363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
No363LP2300XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPrimary Care
Provider Identifiers
StateIdentifier IDID TypeIssuer
NVPENDINGMedicaid
NVPENDINGMedicaid