Healthcare Provider Details
I. General information
NPI: 1215788823
Provider Name (Legal Business Name): SPARSHA SAXENA MD
Entity Type: Individual
Gender: Female
Sole Proprietor: Y
II. Dates (important events)
Enumeration Date: 04/01/2024
Last Update Date: 04/01/2024
Certification Date: 03/31/2024
Deactivation Date:
Reactivation Date:
III. Provider practice location address
751 S BASCOM AVE
SAN JOSE CA
95128-2699
US
IV. Provider business mailing address
24390 SUMMERHILL AVE
LOS ALTOS HILLS CA
94024-4714
US
V. Phone/Fax
- Phone: 408-885-5000
- Fax:
- Phone:
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 390200000X |
| Taxonomy | Student in an Organized Health Care Education/Training Program |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name:
Title or Position:
Credential:
Phone: