MS. MARIA CHARISMA SIDECO LICERALDE APRN PMHNP BC NPI 1134307507

NPI Information

  • NPI: 1134307507
  • Provider Name: MS. MARIA CHARISMA SIDECO LICERALDE, APRN, PMHNP, BC
  • Classification: Registered Nurse - 163WP0809X
  • Specialization: Psychiatric/Mental Health, Adult
  • Entity Type: Individual
  • Address: 80 GREAT OAKS BLVD
    SAN JOSE, CA
    ZIP 95119
  • Phone: (408) 363-3000

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NPI Details

MS. Maria Charisma Sideco Liceralde, APRN, PMHNP, BC is a psychiatric/mental health and adult registered nurse in San Jose, CA. MS. Maria Charisma Sideco Liceralde, APRN, PMHNP, BC NPI is 1134307507. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a female.

The provider's business location address is:

80 GREAT OAKS BLVD
SAN JOSE, CA
ZIP 95119-310
Phone: (408) 363-3000
Fax: (408) 363-3046

The enumeration date for this NPI number is 2/7/2008 and was last updated on 2/7/2008.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No. Taxonomy Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
1163WP0809XRegistered NursePsychiatric/Mental Health, Adult715901CALIFORNIAYes

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 3/30/2025

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