Healthcare Provider Details

I. General information

NPI: 1922523943
Provider Name (Legal Business Name): MAREENI T STANISLAUS MD A MEDICAL CORPORATION
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/10/2017
Last Update Date: 09/09/2025
Certification Date: 09/09/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

350 POSADA LN STE 201
TEMPLETON CA
93465-4060
US

IV. Provider business mailing address

350 POSADA LN STE 201
TEMPLETON CA
93465-4060
US

V. Phone/Fax

Practice location:
  • Phone: 805-434-3000
  • Fax: 805-329-5229
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207V00000X
TaxonomyObstetrics & Gynecology Physician
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code2083P0011X
TaxonomyUndersea and Hyperbaric Medicine (Preventive Medicine) Physician
License Number
License Number State

VIII. Authorized Official

Name: MAREENI STANISLAUS
Title or Position: PRESIDENT
Credential: MD
Phone: 805-434-3000