Healthcare Provider Details

I. General information

NPI: 1629916390
Provider Name (Legal Business Name): RINISHA GIRI MA
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/24/2026
Last Update Date: 03/24/2026
Certification Date: 03/24/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1111 MARKET ST
SAN FRANCISCO CA
94103-1509
US

IV. Provider business mailing address

37814 TACCHELLA WAY
FREMONT CA
94536-3845
US

V. Phone/Fax

Practice location:
  • Phone: 510-579-3452
  • Fax:
Mailing address:
  • Phone: 510-579-3452
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363AM0700X
TaxonomyMedical Physician Assistant
License Number9041
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: