Provider Demographics
NPI:1174181002
Name:NAYAK, SHASHIKALA
Entity Type:Individual
Prefix:
First Name:SHASHIKALA
Middle Name:
Last Name:NAYAK
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 1:4114 CRESTWOOD ST
Mailing Address - Street 2:
Mailing Address - City:FREMONT
Mailing Address - State:CA
Mailing Address - Zip Code:94538-6027
Mailing Address - Country:US
Mailing Address - Phone:510-589-3258
Mailing Address - Fax:
Practice Address - Street 1:80 SARATOGA AVE
Practice Address - Street 2:
Practice Address - City:SANTA CLARA
Practice Address - State:CA
Practice Address - Zip Code:95051-7303
Practice Address - Country:US
Practice Address - Phone:408-351-6400
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-06-05
Last Update Date:2019-06-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174H00000XOther Service ProvidersHealth Educator