Healthcare Provider Details

I. General information

NPI: 1720970965
Provider Name (Legal Business Name): CHISA SUNJA HUFFMAN DNP, MBA, RN, NEA-BC
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/21/2025
Last Update Date: 07/21/2025
Certification Date: 07/20/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1501 TROUSDALE DR
BURLINGAME CA
94010-4506
US

IV. Provider business mailing address

1 ADRIAN CT APT 2631
BURLINGAME CA
94010-2128
US

V. Phone/Fax

Practice location:
  • Phone: 650-696-5400
  • Fax:
Mailing address:
  • Phone: 865-300-5100
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163WA2000X
TaxonomyAdministrator Registered Nurse
License Number95407932
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: