Healthcare Provider Details

I. General information

NPI: 1255218269
Provider Name (Legal Business Name): GUNJANA DUWADI
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/20/2025
Last Update Date: 08/20/2025
Certification Date: 08/19/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3070 PAVAN DR
SAN JOSE CA
95148-3688
US

IV. Provider business mailing address

3070 PAVAN DR
SAN JOSE CA
95148
US

V. Phone/Fax

Practice location:
  • Phone: 650-644-5225
  • Fax:
Mailing address:
  • Phone: 650-644-5225
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LP2300X
TaxonomyPrimary Care Nurse Practitioner
License NumberF08250074
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: