MEDICARE: GENEVIEVE FLANDERS PA-C

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	363A00000X	Physician Assistant	055.0031347	VT
2	363A00000X	Physician Assistant	PA67576	CA
3	363A00000X	Physician Assistant	018126	NY

General Provider Information

NPI Number	:	1821490921
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	GENEVIEVE FLANDERS PA-C

Provider Business Mailing Address
First Line	:	2712 AUGUSTINE DR STE 120
Second Line	:
City	:	SANTA CLARA
State	:	CA
Zip	:	95054-2941
Country	:	US
Telephone Number	:	408-786-9636
Fax Number	:

Provider Business Practice Location Address
First Line	:	2712 AUGUSTINE DR STE 120
Second Line	:
City	:	SANTA CLARA
State	:	CA
Zip	:	95054-2941
Country	:	US
Telephone Number	:	408-786-9636
Fax Number	:

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

Provider Enumeration Date	:	09/19/2014
Last Update Date	:	04/03/2026

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Directions to “ GENEVIEVE FLANDERS PA-C” Practice Location

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