Provider Demographics
NPI:1710600622
Name:JUNEJA, SHIWANI (NP)
Entity Type:Individual
Prefix:
First Name:SHIWANI
Middle Name:
Last Name:JUNEJA
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:107 FARM HILL WAY
Mailing Address - Street 2:
Mailing Address - City:LOS GATOS
Mailing Address - State:CA
Mailing Address - Zip Code:95032-7662
Mailing Address - Country:US
Mailing Address - Phone:732-915-0929
Mailing Address - Fax:
Practice Address - Street 1:15951 LOS GATOS BLVD
Practice Address - Street 2:
Practice Address - City:LOS GATOS
Practice Address - State:CA
Practice Address - Zip Code:95032-3428
Practice Address - Country:US
Practice Address - Phone:408-358-1853
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-09-26
Last Update Date:2022-09-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA95022702363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner