Provider Demographics
NPI:1174493506
Name:BIRUR, EMMA ANNAPURNA (RN, PHN)
Entity type:Individual
Prefix:MS
First Name:EMMA
Middle Name:ANNAPURNA
Last Name:BIRUR
Suffix:
Gender:F
Credentials:RN, PHN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2601 PARKSIDE DR
Mailing Address - Street 2:
Mailing Address - City:FREMONT
Mailing Address - State:CA
Mailing Address - Zip Code:94536-5246
Mailing Address - Country:US
Mailing Address - Phone:510-793-7492
Mailing Address - Fax:
Practice Address - Street 1:2601 PARKSIDE DR
Practice Address - Street 2:
Practice Address - City:FREMONT
Practice Address - State:CA
Practice Address - Zip Code:94536-5246
Practice Address - Country:US
Practice Address - Phone:510-793-7492
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-11-10
Last Update Date:2025-11-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA95100421163W00000X
CA557618163WC1500X
CA210129207163WS0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WS0200XNursing Service ProvidersRegistered NurseSchool
No163W00000XNursing Service ProvidersRegistered Nurse
No163WC1500XNursing Service ProvidersRegistered NurseCommunity Health