Provider Demographics
NPI:1326784448
Name:BOPARAI, KIRANJYOT (FNP-BC)
Entity Type:Individual
Prefix:
First Name:KIRANJYOT
Middle Name:
Last Name:BOPARAI
Suffix:
Gender:F
Credentials:FNP-BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:165 FRANCISCO DR
Mailing Address - Street 2:
Mailing Address - City:SOUTH SAN FRANCISCO
Mailing Address - State:CA
Mailing Address - Zip Code:94080-5931
Mailing Address - Country:US
Mailing Address - Phone:650-636-4523
Mailing Address - Fax:
Practice Address - Street 1:165 FRANCISCO DR
Practice Address - Street 2:
Practice Address - City:SOUTH SAN FRANCISCO
Practice Address - State:CA
Practice Address - Zip Code:94080-5931
Practice Address - Country:US
Practice Address - Phone:650-636-4523
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-05-11
Last Update Date:2022-09-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA480893163W00000X
CA12665363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
No163W00000XNursing Service ProvidersRegistered Nurse