Provider Demographics
NPI:1740014455
Name:NAYAK, ASHA
Entity type:Individual
Prefix:
First Name:ASHA
Middle Name:
Last Name:NAYAK
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 1:1401 MISSION ST APT 710
Mailing Address - Street 2:
Mailing Address - City:SAN FRANCISCO
Mailing Address - State:CA
Mailing Address - Zip Code:94103-2694
Mailing Address - Country:US
Mailing Address - Phone:520-561-3066
Mailing Address - Fax:
Practice Address - Street 1:1401 MISSION ST APT 710
Practice Address - Street 2:
Practice Address - City:SAN FRANCISCO
Practice Address - State:CA
Practice Address - Zip Code:94103-2694
Practice Address - Country:US
Practice Address - Phone:520-561-3066
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-08-27
Last Update Date:2024-08-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
L302568174N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174N00000XOther Service ProvidersLactation Consultant, Non-RN