Provider Demographics
NPI:1992752695
Name:DE SAN JOSE, MAY ALLARDE (NP)
Entity type:Individual
Prefix:MISS
First Name:MAY
Middle Name:ALLARDE
Last Name:DE SAN JOSE
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Gender:F
Credentials:NP
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Mailing Address - Street 1:1600 9TH ST
Mailing Address - Street 2:ROOM 150
Mailing Address - City:SACRAMENTO
Mailing Address - State:CA
Mailing Address - Zip Code:95814-6414
Mailing Address - Country:US
Mailing Address - Phone:916-651-9475
Mailing Address - Fax:909-653-6376
Practice Address - Street 1:3102 E. HIGHLAND AVENUE
Practice Address - Street 2:MEDICAL STAFF OFFICE
Practice Address - City:PATTON
Practice Address - State:CA
Practice Address - Zip Code:92369
Practice Address - Country:US
Practice Address - Phone:909-425-7679
Practice Address - Fax:909-425-6635
Is Sole Proprietor?:No
Enumeration Date:2006-05-28
Last Update Date:2013-08-12
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Provider Licenses
StateLicense IDTaxonomies
CANP15406363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
Q62120Medicare UPIN