Provider Demographics
NPI:1841695897
Name:SHAH, JUHI D
Entity type:Individual
Prefix:
First Name:JUHI
Middle Name:D
Last Name:SHAH
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:JUHI
Other - Middle Name:
Other - Last Name:VYAS
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:24512 AUTUMN MIST WAY
Mailing Address - Street 2:
Mailing Address - City:HAYWARD
Mailing Address - State:CA
Mailing Address - Zip Code:94544-2170
Mailing Address - Country:US
Mailing Address - Phone:678-231-7499
Mailing Address - Fax:
Practice Address - Street 1:490 MARKET PL
Practice Address - Street 2:
Practice Address - City:SAN RAMON
Practice Address - State:CA
Practice Address - Zip Code:94583
Practice Address - Country:US
Practice Address - Phone:925-327-0435
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-10-31
Last Update Date:2024-10-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ28RI03662400183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA71604OtherCALIFORNIA PHARMACIST LICENSE