Vanessa Beatriz Kusisto, MD
Student in an Organized Health Care Education/Training Program in Santa Clara, CA. Individual provider (NPI-1).
NPI number1053052829
StatusActive
Last updated in NPPESDec 11, 2024
Details
- NPI
- 1053052829
- Entity type
- Individual (NPI-1)
- Name
- Vanessa Beatriz Kusisto
- Credential
- MD
- Sex
- Female
- Sole proprietor
- No
- Enumeration date
- Apr 5, 2022
- Certification date
- Dec 11, 2024
- Last updated
- Dec 11, 2024
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 390200000X | Student in an Organized Health Care Education/Training Program | – | – | Yes |
Practice location
700 Lawrence ExpySanta Clara, CA 95051-5173
Phone 408-851-3842
Mailing address
2548 Sandhill WaySanta Clara, CA 95051-1244
Phone 317-727-9216
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