Provider Demographics
NPI:1043074859
Name:PANDIT, SAMIKSHA
Entity Type:Individual
Prefix:
First Name:SAMIKSHA
Middle Name:
Last Name:PANDIT
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:18334 JOSEPH DR
Mailing Address - Street 2:
Mailing Address - City:CASTRO VALLEY
Mailing Address - State:CA
Mailing Address - Zip Code:94546-2204
Mailing Address - Country:US
Mailing Address - Phone:415-702-5724
Mailing Address - Fax:
Practice Address - Street 1:1955 SAN PABLO AVE
Practice Address - Street 2:
Practice Address - City:OAKLAND
Practice Address - State:CA
Practice Address - Zip Code:94612-1367
Practice Address - Country:US
Practice Address - Phone:510-830-3910
Practice Address - Fax:510-433-1161
Is Sole Proprietor?:No
Enumeration Date:2024-02-12
Last Update Date:2024-02-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA95136056163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse