Provider Demographics
NPI:1659360139
Name:PATEL, SONYA SHETH (DO)
Entity Type:Individual
Prefix:DR
First Name:SONYA
Middle Name:SHETH
Last Name:PATEL
Suffix:
Gender:F
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:777 KNOWLES DR STE 10
Mailing Address - Street 2:
Mailing Address - City:LOS GATOS
Mailing Address - State:CA
Mailing Address - Zip Code:95032-1417
Mailing Address - Country:US
Mailing Address - Phone:510-846-2103
Mailing Address - Fax:408-374-3703
Practice Address - Street 1:777 KNOWLES DR STE 10
Practice Address - Street 2:
Practice Address - City:LOS GATOS
Practice Address - State:CA
Practice Address - Zip Code:95032-1417
Practice Address - Country:US
Practice Address - Phone:510-846-2103
Practice Address - Fax:408-374-0703
Is Sole Proprietor?:No
Enumeration Date:2005-10-18
Last Update Date:2012-04-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA2OA80452084N0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084N0400XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyNeurology
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA00AX80450Medicaid
CA00AX80450Medicaid
CAI13211Medicare UPIN