Provider Demographics
NPI:1083776512
Name:GEORGE, REKHA (NP)
Entity Type:Individual
Prefix:
First Name:REKHA
Middle Name:
Last Name:GEORGE
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4725 1ST ST STE 100
Mailing Address - Street 2:
Mailing Address - City:PLEASANTON
Mailing Address - State:CA
Mailing Address - Zip Code:94566-7366
Mailing Address - Country:US
Mailing Address - Phone:925-734-3333
Mailing Address - Fax:925-734-9294
Practice Address - Street 1:4725 1ST ST STE 100
Practice Address - Street 2:
Practice Address - City:PLEASANTON
Practice Address - State:CA
Practice Address - Zip Code:94566-7366
Practice Address - Country:US
Practice Address - Phone:925-734-3333
Practice Address - Fax:925-734-9294
Is Sole Proprietor?:No
Enumeration Date:2006-12-14
Last Update Date:2023-10-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA95021723163W00000X
IN28156326A163W00000X
CA95000580363LW0102X, 363L00000X
IN71002965363LW0102X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
No163W00000XNursing Service ProvidersRegistered Nurse
No363LW0102XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerWomen's Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
IN200949210Medicaid