Provider Demographics
NPI:1700665221
Name:RAJESH, SHIKHA (PA-C)
Entity Type:Individual
Prefix:
First Name:SHIKHA
Middle Name:
Last Name:RAJESH
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1290 BEETHOVEN CMN UNIT 201
Mailing Address - Street 2:
Mailing Address - City:FREMONT
Mailing Address - State:CA
Mailing Address - Zip Code:94538-4623
Mailing Address - Country:US
Mailing Address - Phone:469-396-6455
Mailing Address - Fax:
Practice Address - Street 1:1764 LEE WAY
Practice Address - Street 2:
Practice Address - City:MILPITAS
Practice Address - State:CA
Practice Address - Zip Code:95035-9013
Practice Address - Country:US
Practice Address - Phone:469-396-6455
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-09-25
Last Update Date:2024-01-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAPA63964363A00000X
390200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant