Provider Demographics
NPI:1093887622
Name:ADAMS, NOHRA REBECCA (PA, MPH)
Entity Type:Individual
Prefix:MS
First Name:NOHRA
Middle Name:REBECCA
Last Name:ADAMS
Suffix:
Gender:F
Credentials:PA, MPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:101 E SAN FERNANDO ST APT 123
Mailing Address - Street 2:
Mailing Address - City:SAN JOSE
Mailing Address - State:CA
Mailing Address - Zip Code:95112-7444
Mailing Address - Country:US
Mailing Address - Phone:209-324-3907
Mailing Address - Fax:
Practice Address - Street 1:5440 THORNWOOD DR
Practice Address - Street 2:
Practice Address - City:SAN JOSE
Practice Address - State:CA
Practice Address - Zip Code:95123-1217
Practice Address - Country:US
Practice Address - Phone:408-281-9777
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-11-15
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAPA 18287363AM0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AM0700XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantMedical