Provider Demographics
NPI:1609532829
Name:NEJAT, ALEXANDRE MOHAMMED
Entity Type:Individual
Prefix:
First Name:ALEXANDRE
Middle Name:MOHAMMED
Last Name:NEJAT
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1177 ROSAMUND DR
Mailing Address - Street 2:
Mailing Address - City:SAN RAMON
Mailing Address - State:CA
Mailing Address - Zip Code:94582-5392
Mailing Address - Country:US
Mailing Address - Phone:510-676-7775
Mailing Address - Fax:
Practice Address - Street 1:SCHOOL OF NURSING 102 CURRIS CENTER
Practice Address - Street 2:
Practice Address - City:MURRAY
Practice Address - State:KY
Practice Address - Zip Code:42071
Practice Address - Country:US
Practice Address - Phone:800-272-4678
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-11-11
Last Update Date:2021-11-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA95086665367500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367500000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Anesthetist, Certified Registered