Healthcare Provider Details
I. General information
NPI: 1114750171
Provider Name (Legal Business Name): RANIKA MAHARAJ FNP-C
Entity Type: Individual
Gender: Female
Sole Proprietor: Y
II. Dates (important events)
Enumeration Date: 08/23/2024
Last Update Date: 08/23/2024
Certification Date: 08/23/2024
Deactivation Date:
Reactivation Date:
III. Provider practice location address
2878 YGNACIO VALLEY RD
WALNUT CREEK CA
94598-3534
US
IV. Provider business mailing address
8583 WICKLOW LN
DUBLIN CA
94568-1145
US
V. Phone/Fax
- Phone: 925-658-5338
- Fax:
- Phone: 925-404-3502
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 363LF0000X |
| Taxonomy | Family Nurse Practitioner |
| License Number | 95028578 |
| License Number State | CA |
VIII. Authorized Official
Name:
Title or Position:
Credential:
Phone: