Healthcare Provider Details

I. General information

NPI: 1578494837
Provider Name (Legal Business Name): ELEVATE ADDICTION & MENTAL HEALTH NURSING CORPORATION PC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/26/2026
Last Update Date: 05/26/2026
Certification Date: 05/26/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2915 PASEO ROBLES AVE
SAN MARTIN CA
95046-9706
US

IV. Provider business mailing address

2915 PASEO ROBLES AVE
SAN MARTIN CA
95046-9706
US

V. Phone/Fax

Practice location:
  • Phone: 408-500-9650
  • Fax:
Mailing address:
  • Phone: 408-500-9650
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License Number
License Number State

VIII. Authorized Official

Name: PAWANJIT K DHILLON
Title or Position: PRESIDENT
Credential: NP
Phone: 408-500-9650