Healthcare Provider Details

I. General information

NPI: 1316106271
Provider Name (Legal Business Name): BEENU ANEJA FNP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/05/2008
Last Update Date: 06/05/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

584 N SUNRISE AVE SUITE 100
ROSEVILLE CA
95661-3035
US

IV. Provider business mailing address

584 N SUNRISE AVE SUITE 100
ROSEVILLE CA
95661-3035
US

V. Phone/Fax

Practice location:
  • Phone: 916-773-2990
  • Fax: 916-773-5154
Mailing address:
  • Phone: 916-773-2990
  • Fax: 916-773-5154

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number16183
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: