Provider Demographics
NPI:1740934298
Name:PUNJANI, SANGEETA SINGH
Entity type:Individual
Prefix:
First Name:SANGEETA
Middle Name:SINGH
Last Name:PUNJANI
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 1:5305 GATHER WAY
Mailing Address - Street 2:
Mailing Address - City:FAIRFIELD
Mailing Address - State:CA
Mailing Address - Zip Code:94534-4275
Mailing Address - Country:US
Mailing Address - Phone:707-205-9989
Mailing Address - Fax:
Practice Address - Street 1:610 16TH ST STE 310
Practice Address - Street 2:
Practice Address - City:OAKLAND
Practice Address - State:CA
Practice Address - Zip Code:94612-1284
Practice Address - Country:US
Practice Address - Phone:888-852-1988
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-02-03
Last Update Date:2022-02-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CANP95017355363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner