Healthcare Provider Details

I. General information

NPI: 1396179867
Provider Name (Legal Business Name): TINA SINGH ARNEJA FNP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/02/2013
Last Update Date: 04/19/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2630 W EL CAMINO REAL
MOUNTAIN VIEW CA
94040-1117
US

IV. Provider business mailing address

2630 W EL CAMINO REAL
MOUNTAIN VIEW CA
94040-1117
US

V. Phone/Fax

Practice location:
  • Phone: 866-389-2727
  • Fax:
Mailing address:
  • Phone: 866-389-2727
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License Number779000
License Number StateCA
# 2
Primary TaxonomyN
Taxonomy Code163WC1500X
TaxonomyCommunity Health Registered Nurse
License Number78325
License Number StateCA
# 3
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number23385
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: