Provider Demographics
NPI:1467275438
Name:SUKUMAR, SANJANA
Entity type:Individual
Prefix:
First Name:SANJANA
Middle Name:
Last Name:SUKUMAR
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1752 LOVELAND CT
Mailing Address - Street 2:
Mailing Address - City:SANTA CLARA
Mailing Address - State:CA
Mailing Address - Zip Code:95050-3998
Mailing Address - Country:US
Mailing Address - Phone:408-921-8858
Mailing Address - Fax:
Practice Address - Street 1:1410 MARSHALL ST
Practice Address - Street 2:
Practice Address - City:REDWOOD CITY
Practice Address - State:CA
Practice Address - Zip Code:94063-2503
Practice Address - Country:US
Practice Address - Phone:650-372-4080
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-11-06
Last Update Date:2024-11-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes175T00000XOther Service ProvidersPeer Specialist