Healthcare Provider Details

I. General information

NPI: 1952845810
Provider Name (Legal Business Name): CAROLINE NJANE
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 12/12/2016
Last Update Date: 04/20/2026
Certification Date: 04/20/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

38425 CROSSPOINTE CMN
FREMONT CA
94536-3289
US

IV. Provider business mailing address

38425 CROSSPOINTE CMN
FREMONT CA
94536-3289
US

V. Phone/Fax

Practice location:
  • Phone: 410-710-7072
  • Fax:
Mailing address:
  • Phone: 410-710-7072
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberR172628
License Number StateMD
# 2
Primary TaxonomyN
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License NumberR172628
License Number StateMD
# 3
Primary TaxonomyY
Taxonomy Code363LP2300X
TaxonomyPrimary Care Nurse Practitioner
License Number95032213
License Number StateCA
# 4
Primary TaxonomyN
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License Number95388004
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: