Provider Demographics
NPI:1487412961
Name:LIM, HAZEL ARANAS-BANTILAN
Entity type:Individual
Prefix:MISS
First Name:HAZEL
Middle Name:ARANAS-BANTILAN
Last Name:LIM
Suffix:
Gender:F
Credentials:
Other - Prefix:MISS
Other - First Name:HAZEL
Other - Middle Name:ARANAS
Other - Last Name:BANTILAN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:5837 MAYHEWS LANDING RD
Mailing Address - Street 2:
Mailing Address - City:NEWARK
Mailing Address - State:CA
Mailing Address - Zip Code:94560-3126
Mailing Address - Country:US
Mailing Address - Phone:341-529-6081
Mailing Address - Fax:
Practice Address - Street 1:425 E SANTA CLARA ST
Practice Address - Street 2:
Practice Address - City:SAN JOSE
Practice Address - State:CA
Practice Address - Zip Code:95113-1936
Practice Address - Country:US
Practice Address - Phone:408-299-0462
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-03-11
Last Update Date:2024-03-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA95337368163WP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WP0808XNursing Service ProvidersRegistered NursePsychiatric/Mental Health