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General NPI Number Information
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NPI Number | 1033002100
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Entity Type | Organization
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Legal Business Name | SHAISTA Y KHAN
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Dates
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Enumeration Date | 05/29/2025
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Last Update Date | 05/29/2025
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Provider Practice Location Address
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Address Line | 899 SANTA CRUZ AVE STE 200
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City | MENLO PARK
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State | CA
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Zip | 94025-4643
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Country | US
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Telephone | 650-910-2505
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Fax |
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Provider Business Mailing Address
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Address Line | 567 GREATHOUSE DR
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City | MILPITAS
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State | CA
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Zip | 95035-2818
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Country | US
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Telephone | 650-910-2505
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Fax |
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Authorized Official
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Title or Position | PSYCHIATRIST.
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Name | SHAISTA KHAN
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Credential | MD
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Telephone | 650-910-2505
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QM0850X
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Taxonomy Name | Adult Mental Health Clinic/Center
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License Number |
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License Number State |
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