Provider Demographics
NPI:1235864497
Name:SHRESTHA, ALIZA (RN)
Entity Type:Individual
Prefix:
First Name:ALIZA
Middle Name:
Last Name:SHRESTHA
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1501 NOB HILL AVE # 6
Mailing Address - Street 2:
Mailing Address - City:PINOLE
Mailing Address - State:CA
Mailing Address - Zip Code:94564-2426
Mailing Address - Country:US
Mailing Address - Phone:510-205-1454
Mailing Address - Fax:
Practice Address - Street 1:1501 NOB HILL AVE
Practice Address - Street 2:
Practice Address - City:PINOLE
Practice Address - State:CA
Practice Address - Zip Code:94564-2426
Practice Address - Country:US
Practice Address - Phone:510-205-1454
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-07-21
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA95121512163WP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WP0808XNursing Service ProvidersRegistered NursePsychiatric/Mental Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA95121512OtherBRN