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Data from the NPPES registry. May not reflect recent changes — verify at nppes.cms.hhs.gov.

MS. MARIA CHARISMA SIDECO LICERALDE, APRN, PMHNP, BC

Active Sole Proprietor

MS. MARIA CHARISMA SIDECO LICERALDE, APRN, PMHNP, BC is a Substance Abuse Psychiatric Nurse healthcare provider located in SAN JOSE, California. NPI 1134307507 is currently active in the NPPES registry. Verify at CMS.

Substance Abuse Psychiatric Nurse · SAN JOSE, CA

Registration Details

NPI Number
1134307507
Provider Type
Individual
Gender
Female
NPI Issued
Feb 7, 2008 (18.50681587907 yrs)
Last Updated
Feb 7, 2008
License
715901 (CA)
Sole Proprietor
Yes

Practice Information

Address
80 GREAT OAKS BLVD
SAN JOSE, CA, 951191310
Browse CA providers · Browse ZIP 95119
Phone
4083633000
Fax
4083633046
Primary Specialty
Substance Abuse Psychiatric Nurse
163WP0809X

Other Substance Abuse Psychiatric Nurse Providers in SAN JOSE, CA

Name Credential NPI
MR. DAVID SISSON CNS 1588686364
KEVIN AUSTIN MCKELLAR R.N. 1043584816
MR. JESS LARAZA REYES REGISTERED NURSE 1962923524
MRS. NGA TUYET DANG 1235648536
Data sourced from the NPPES National Provider Identifier registry. This information is for informational purposes only and is not a substitute for verifying credentials with the appropriate licensing authority. For official verification, use the NPPES NPI Registry or the relevant state medical board.