Provider Demographics
NPI:1366025132
Name:ARAJ, MARY E (PNP)
Entity Type:Individual
Prefix:
First Name:MARY
Middle Name:E
Last Name:ARAJ
Suffix:
Gender:F
Credentials:PNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2002 VALLEY OAK RD
Mailing Address - Street 2:
Mailing Address - City:PLEASANTON
Mailing Address - State:CA
Mailing Address - Zip Code:94588-8213
Mailing Address - Country:US
Mailing Address - Phone:510-676-8439
Mailing Address - Fax:
Practice Address - Street 1:4000 CIVIC CENTER DR STE 201
Practice Address - Street 2:
Practice Address - City:SAN RAFAEL
Practice Address - State:CA
Practice Address - Zip Code:94903-5232
Practice Address - Country:US
Practice Address - Phone:415-479-8642
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-04-30
Last Update Date:2021-04-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA95015608363LP0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPediatrics