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General NPI Number Information
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NPI Number | 1467275438
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Entity Type | Individual
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Provider Name | SANJANA SUKUMAR
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Gender | Female
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Dates
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Enumeration Date | 11/06/2024
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Last Update Date | 11/06/2024
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Provider Practice Location Address
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Address Line | 1410 MARSHALL ST
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City | REDWOOD CITY
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State | CA
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Zip | 94063-2503
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Country | US
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Telephone | 650-372-4080
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Fax |
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Provider Business Mailing Address
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Address Line | 1752 LOVELAND CT
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City | SANTA CLARA
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State | CA
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Zip | 95050-3998
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Country | US
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Telephone | 408-921-8858
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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 | 175T00000X
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Taxonomy Name | Peer Specialist
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License Number |
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License Number State |
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