Healthcare Provider Details

I. General information

NPI: 1659476331
Provider Name (Legal Business Name): SHAJITHA NAWAZ M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 09/14/2006
Last Update Date: 09/11/2025
Certification Date: 02/14/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

40925 COUNTY CENTER DR STE 200
TEMECULA CA
92591-6037
US

IV. Provider business mailing address

40925 COUNTY CENTER DR STE 200
TEMECULA CA
92591-6037
US

V. Phone/Fax

Practice location:
  • Phone: 951-600-6300
  • Fax:
Mailing address:
  • Phone: 951-600-6300
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2084P0800X
TaxonomyPsychiatry Physician
License Number2003031776
License Number StateMO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: