Healthcare Provider Details
I. General information
NPI: 1386822385
Provider Name (Legal Business Name): USHA KIRAN GAJI RN, PHN, MSN/ED
Entity Type: Individual
Gender: Female
Sole Proprietor: Y
II. Dates (important events)
Enumeration Date: 02/01/2008
Last Update Date: 02/01/2008
Certification Date:
Deactivation Date:
Reactivation Date:
III. Provider practice location address
1445 VETERANS MEMORIAL CIR
YUBA CITY CA
95993-3011
US
IV. Provider business mailing address
1445 VETERANS MEMORIAL CIR
YUBA CITY CA
95993-3011
US
V. Phone/Fax
- Phone: 530-822-7215
- Fax: 530-822-7223
- Phone: 530-822-7215
- Fax: 530-822-7223
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 163WC1500X |
| Taxonomy | Community Health Registered Nurse |
| License Number | 601842 |
| License Number State | CA |
VIII. Authorized Official
Name:
Title or Position:
Credential:
Phone: