MEDICARE: GEETHA SHIVAKUMAR M.D.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	2084P0800X	Psychiatry Physician	M0567	TX

General Provider Information

NPI Number	:	1467406454
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	GEETHA SHIVAKUMAR M.D.

Provider Business Mailing Address
First Line	:	19000 HOMESTEAD RD
Second Line	:
City	:	CUPERTINO
State	:	CA
Zip	:	95014-0712
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	19000 HOMESTEAD RD FL 2
Second Line	:
City	:	CUPERTINO
State	:	CA
Zip	:	95014-0712
Country	:	US
Telephone Number	:	408-366-4400
Fax Number	:	408-366-4405

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	05/22/2006
Last Update Date	:	08/04/2025

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