Provider Demographics
NPI:1275050056
Name:DENG, ZHUOSHU (APRN, CPNP)
Entity Type:Individual
Prefix:
First Name:ZHUOSHU
Middle Name:
Last Name:DENG
Suffix:
Gender:F
Credentials:APRN, CPNP
Other - Prefix:
Other - First Name:SHIRLEY
Other - Middle Name:
Other - Last Name:DENG
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:APRN
Mailing Address - Street 1:1650 WALNUT ST
Mailing Address - Street 2:
Mailing Address - City:BERKELEY
Mailing Address - State:CA
Mailing Address - Zip Code:94709-1606
Mailing Address - Country:US
Mailing Address - Phone:510-848-2566
Mailing Address - Fax:
Practice Address - Street 1:1650 WALNUT ST
Practice Address - Street 2:
Practice Address - City:BERKELEY
Practice Address - State:CA
Practice Address - Zip Code:94709-1606
Practice Address - Country:US
Practice Address - Phone:203-503-3000
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-08-23
Last Update Date:2021-11-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT12.007188363LP0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPediatrics