Healthcare Provider Details
I. General information
NPI: 1417839119
Provider Name (Legal Business Name): ESHA DASU
Entity Type: Individual
Gender: Female
Sole Proprietor: Y
II. Dates (important events)
Enumeration Date: 07/23/2025
Last Update Date: 04/23/2026
Certification Date: 04/23/2026
Deactivation Date:
Reactivation Date:
III. Provider practice location address
1356 RIDDER PARK DR
SAN JOSE CA
95131-2313
US
IV. Provider business mailing address
9015 MURRAY AVE STE 100
GILROY CA
95020-3675
US
V. Phone/Fax
- Phone: 408-225-9163
- 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: