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General NPI Number Information
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NPI Number | 1356872436
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Entity Type | Individual
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Provider Name | PUJA PRASAD DNP, NP
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Gender | Female
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Dates
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Enumeration Date | 03/21/2017
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Last Update Date | 01/03/2019
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Provider Practice Location Address
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Address Line | 751 S BASCOM AVE
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City | SAN JOSE
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State | CA
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Zip | 95128-2604
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Country | US
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Telephone | 408-272-6050
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Fax |
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Provider Business Mailing Address
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Address Line | 1950 MILITARY AVE
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City | SEASIDE
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State | CA
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Zip | 93955-3415
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Country | US
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Telephone | 831-383-2555
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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 | 363LP0808X
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Taxonomy Name | Psychiatric/Mental Health Nurse Practitioner
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License Number | 95008105
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License Number State | CA
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