Active NPI
Jose Puente Jr.
- Licensed Vocational Nurse
- San Martin, CA
National Provider Identifier
1871302224
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Licensed Vocational Nurse
- License
- 210961
- Practice address
- 90 Highland Ave
San Martin, CA 95046-9504 - Phone
- (408) 852-2420
- NPI assigned
- Dec 31, 2024
- Last updated
- Jan 15, 2025
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Licensed Vocational Nurse | 164X00000X | 210961 | CA | Primary |
Addresses
Primary practice location
90 Highland Ave
San Martin, CA 95046-9504
Mailing address
5959 Gemwood Loop
San Jose Ca 95123
San Jose, CA 95123
Phone (408) 771-3740
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
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 210961 | CA | MD | Licensed Vocational Nurse |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1735603200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1736899200000",
"number": "1871302224",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "5959 GEMWOOD LOOP",
"address_2": "SAN JOSE CA 95123",
"city": "SAN JOSE",
"state": "CA",
"postal_code": "95123",
"telephone_number": "408-771-3740"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "90 HIGHLAND AVE",
"city": "SAN MARTIN",
"state": "CA",
"postal_code": "950469504",
"telephone_number": "408-852-2420"
}
],
"practiceLocations": [],
"basic": {
"last_name": "PUENTE",
"first_name": "JOSE",
"name_suffix": "Jr.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2024-12-31",
"last_updated": "2025-01-15",
"certification_date": "2025-01-15",
"status": "A"
},
"taxonomies": [
{
"code": "164X00000X",
"taxonomy_group": "",
"desc": "Licensed Vocational Nurse",
"state": "CA",
"license": "210961",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in San Martin, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 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.