Healthcare Provider Details

I. General information

NPI: 1174972707
Provider Name (Legal Business Name): ANJANA CHAUHAN NP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/04/2016
Last Update Date: 01/03/2022
Certification Date: 03/23/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

500 UNIVERSITY AVE STE 250
SACRAMENTO CA
95825-6525
US

IV. Provider business mailing address

761 BLUE SAGE DR
SUNNYVALE CA
94086-6515
US

V. Phone/Fax

Practice location:
  • Phone: 916-680-9510
  • Fax: 916-680-9550
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number95003247
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: