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General NPI Number Information
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NPI Number | 1003439514
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Entity Type | Individual
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Provider Name | SHILPA MANU MAKHIJA
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Gender | Female
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Dates
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Enumeration Date | 05/19/2020
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Last Update Date | 12/08/2021
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Provider Practice Location Address
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Address Line | HAYWARD WELLNESS CENTER 664 SOUTHLAND MALL DRIVE
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City | HAYWARD
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State | CA
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Zip | 94545-5439
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Country | US
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Telephone | 510-501-2471
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Fax |
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Provider Business Mailing Address
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Address Line | 25119 VALLEY OAK DR
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City | CASTRO VALLEY
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State | CA
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Zip | 94552-5439
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | 95014823
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License Number State | CA
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Taxonomy #2
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Taxonomy Code | 163W00000X
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Taxonomy Name | Registered Nurse
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License Number | 847047
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License Number State | CA
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