Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.

Blue Sky Surgical

Organization Registered Nurse First Assistant · NPI 1104714963

Blue Sky Surgical is a Registered Nurse First Assistant in San Jose, California. Registered with an NPI since 2025.

In the registry since
2025
Specialties on file
2

Practice location Address checks out

2951 Wall St
San Jose, CA 95111-4600
Phone: (408) 603-6553
Show map & directions

Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Registered Nurse First Assistant (primary) Taxonomy 163WR0006X
Nursing Care Agency Taxonomy 251J00000X

Record details

NPI number1104714963
Entity typeOrganization (Type 2)
Organization subpartNo
Authorized official Jenny Phan — Owner · (650) 935-4745
NPI enumeratedJune 27, 2025
Last updated in NPPESNovember 15, 2025
Certification dateNovember 15, 2025
Mailing address2951 Wall St, San Jose, CA 95111-4600

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