Individual provider · Type 1 NPI
Raven Cross
Psychiatric/Mental Health Nurse Practitioner · San Jose, CA
NPI number
1114596624
Active
Practice location
1165 Lincoln Ave Ste 150
San Jose, CA 95125-3045
Other practice locations
- 1898 The Alameda, San Jose, CA 95126-1733 · (408) 928-1700
Specialties and licenses
| Taxonomy | Code | License |
|---|---|---|
| Psychiatric/Mental Health Nurse Practitioner Primary | 363LP0808X | 95019647 (CA) |
| Child & Adolescent Psychiatric/Mental Health Registered Nurse | 163WP0807X | 95142217 (CA) |
| Psychiatric/Mental Health Nurse Practitioner | 363LP0808X | 0024183375 (VA) |
Psychiatric/Mental Health Nurse Practitioner: Definition to come...
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About NPI 1114596624
Raven Cross's National Provider Identifier is 1114596624, issued on Jun 18, 2021. The primary taxonomy on file is Psychiatric/Mental Health Nurse Practitioner (363LP0808X), and the practice location is in San Jose, CA. The record was last updated on Aug 14, 2026.