Individual provider Active NPI

Clowee Lyka Valdez Bonifacio

  • Rehabilitation Practitioner
  • San Jose, CA
National Provider Identifier
1477347474
Registry record updated Sep 15, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Rehabilitation PractitionerTaxonomy code 225400000X
Practice address
2832 Sand Point Dr
San Jose, CA 95148-2920
Phone
(408) 912-6917
NPI assigned
Apr 7, 2025
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 15, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Rehabilitation PractitionerGroup: 193400000X SINGLE SPECIALTY GROUP 225400000X CA Primary

Addresses

Primary practice location

2832 Sand Point Dr
San Jose, CA 95148-2920

Mailing address

2832 Sand Point Dr
San Jose, CA 95148-2920
Phone (408) 912-6917

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": "1743984000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1757894400000",
    "number": "1477347474",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2832 SAND POINT DR",
            "city": "SAN JOSE",
            "state": "CA",
            "postal_code": "951482920",
            "telephone_number": "408-912-6917"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2832 SAND POINT DR",
            "city": "SAN JOSE",
            "state": "CA",
            "postal_code": "951482920",
            "telephone_number": "408-912-6917"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BONIFACIO",
        "first_name": "CLOWEE LYKA",
        "middle_name": "VALDEZ",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2025-04-07",
        "last_updated": "2025-09-15",
        "certification_date": "2025-09-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225400000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Rehabilitation Practitioner",
            "state": "CA",
            "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 Sep 15, 2025; 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.