RAVEN CROSS NPI 1114596624

NPI Information

  • NPI: 1114596624
  • Provider Name: RAVEN CROSS
  • Classification: Nurse Practitioner - 363LP0808X
  • Specialization: Psychiatric/Mental Health
  • Entity Type: Individual
  • PECOS Registration: Yes
  • Address: 1165 LINCOLN AVE STE 150
    SAN JOSE, CA
    ZIP 95125
  • Phone: (408) 372-8580

Map and Directions

Get Directions

NPI Details

Raven Cross is a psychiatric/mental health nurse practitioner in San Jose, CA. Raven Cross NPI is 1114596624. The provider is registered as an individual entity type and is a multiple single specialty group.

The NPPES NPI record indicates the provider is a female.

The provider's business location address is:

1165 LINCOLN AVE STE 150
SAN JOSE, CA
ZIP 95125-045
Phone: (408) 372-8580

The NPI 1114596624 is registered in the Medicare Provider, Enrollment, Chain and Ownership System (PECOS). The provider is legally eligible to order and refer Part B (Clinical Laboratory and Imaging), Durable Medical Equipment, Part A Home Health Agency (HHA), Power Mobility Devices.

The enumeration date for this NPI number is 6/18/2021 and was last updated on 5/25/2023.

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
1163WP0807XRegistered NursePsychiatric/Mental Health, Child & Adolescent95142217CALIFORNIANo
2363LP0808XNurse PractitionerPsychiatric/Mental Health0024183375VIRGINIANo
3363LP0808XNurse PractitionerPsychiatric/Mental Health95019647CALIFORNIAYes

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: 11/21/2025

NPI Synchronization or Removal

All materials and services on this site are provided on an "as is" and "as available" basis without warranty of any kind. The NPI record is maintained by the National Plan & Provider Enumeration System (NPPES) and anyone may request this information and other NPPES health care provider data from HHS under The Freedom of Information Act (FOIA), Title 5 of the United States Code, section 552. To update the NPI records please contact the NPPES.

Previous NPI
Next NPI