Individual provider Active NPI

Meleena Iliana Raygoza

  • Student in an Organized Health Care Education/Training Program
  • San Jose, CA
National Provider Identifier
1023609583
Registry record updated Mar 14, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Student in an Organized Health Care Education/Training ProgramTaxonomy code 390200000X
Practice address
160 E Virginia St Ste 280
San Jose, CA 95112-5817
Phone
(408) 938-2113
NPI assigned
Jan 28, 2021
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 14, 2023

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Counselor 101YM0800X
Behavior Technician 106S00000X
Student in an Organized Health Care Education/Training Program 390200000X Primary

Addresses

Primary practice location

160 E Virginia St Ste 280
San Jose, CA 95112-5817

Mailing address

160 E Virginia St Ste 100
San Jose, CA 95112-5865
Phone (408) 938-2113

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1611792000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1678752000000",
    "number": "1023609583",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "160 E VIRGINIA ST STE 100",
            "city": "SAN JOSE",
            "state": "CA",
            "postal_code": "951125865",
            "telephone_number": "408-938-2113"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "160 E VIRGINIA ST STE 280",
            "city": "SAN JOSE",
            "state": "CA",
            "postal_code": "951125817",
            "telephone_number": "408-938-2113"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RAYGOZA",
        "first_name": "MELEENA",
        "middle_name": "ILIANA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-01-28",
        "last_updated": "2023-03-14",
        "certification_date": "2023-03-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "106S00000X",
            "taxonomy_group": "",
            "desc": "Behavior Technician",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in San Jose, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 14, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.