Healthcare Provider Details

I. General information

NPI: 1215219480
Provider Name (Legal Business Name): SHARANYA MUNSHI LCGC
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

Provider Other Name: SHARANYA KUMARAVEL

II. Dates (important events)

Enumeration Date: 09/14/2011
Last Update Date: 05/23/2024
Certification Date: 05/23/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5901 OPTICAL CT
SAN JOSE CA
95138-1400
US

IV. Provider business mailing address

1242 MAGGIO CT
CAMPBELL CA
95008-6327
US

V. Phone/Fax

Practice location:
  • Phone: 408-972-3331
  • Fax:
Mailing address:
  • Phone: 408-710-2120
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code170300000X
TaxonomyGenetic Counselor (M.S.)
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: