Provider Demographics
NPI:1629251707
Name:PANDYA, BERNADETTE PRIYA (RN, PHN, BSN, MSN)
Entity Type:Individual
Prefix:MS
First Name:BERNADETTE
Middle Name:PRIYA
Last Name:PANDYA
Suffix:
Gender:F
Credentials:RN, PHN, BSN, MSN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:24085 AMADOR ST
Mailing Address - Street 2:SUITE110
Mailing Address - City:HAYWARD
Mailing Address - State:CA
Mailing Address - Zip Code:94544-1222
Mailing Address - Country:US
Mailing Address - Phone:510-670-8456
Mailing Address - Fax:
Practice Address - Street 1:24085 AMADOR ST
Practice Address - Street 2:SUITE110
Practice Address - City:HAYWARD
Practice Address - State:CA
Practice Address - Zip Code:94544-1222
Practice Address - Country:US
Practice Address - Phone:510-670-8456
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-12-11
Last Update Date:2007-12-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA544625163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse