Healthcare Provider Details

I. General information

NPI: 1083776512
Provider Name (Legal Business Name): REKHA GEORGE NP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 12/14/2006
Last Update Date: 10/23/2023
Certification Date: 10/23/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4725 1ST ST STE 100
PLEASANTON CA
94566-7366
US

IV. Provider business mailing address

4725 1ST ST STE 100
PLEASANTON CA
94566-7366
US

V. Phone/Fax

Practice location:
  • Phone: 925-734-3333
  • Fax: 925-734-9294
Mailing address:
  • Phone: 925-734-3333
  • Fax: 925-734-9294

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License Number95021723
License Number StateCA
# 2
Primary TaxonomyN
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License Number28156326A
License Number StateIN
# 3
Primary TaxonomyN
Taxonomy Code363LW0102X
TaxonomyWomen's Health Nurse Practitioner
License Number95000580
License Number StateCA
# 4
Primary TaxonomyN
Taxonomy Code363LW0102X
TaxonomyWomen's Health Nurse Practitioner
License Number71002965
License Number StateIN
# 5
Primary TaxonomyY
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License Number95000580
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: