Provider Demographics
NPI:1881242782
Name:BALAYAN, SHAINA-JILL S (DNP, MS, CPNP)
Entity type:Individual
Prefix:
First Name:SHAINA-JILL
Middle Name:S
Last Name:BALAYAN
Suffix:
Gender:F
Credentials:DNP, MS, CPNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Last Name Type:
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Mailing Address - Street 1:39500 FREMONT BLVD STE 100
Mailing Address - Street 2:
Mailing Address - City:FREMONT
Mailing Address - State:CA
Mailing Address - Zip Code:94538-2101
Mailing Address - Country:US
Mailing Address - Phone:510-248-1800
Mailing Address - Fax:510-687-1356
Practice Address - Street 1:39500 FREMONT BLVD STE 100
Practice Address - Street 2:
Practice Address - City:FREMONT
Practice Address - State:CA
Practice Address - Zip Code:94538-2101
Practice Address - Country:US
Practice Address - Phone:510-248-1800
Practice Address - Fax:510-687-1356
Is Sole Proprietor?:No
Enumeration Date:2019-09-04
Last Update Date:2023-07-27
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
CA95217744163WP0200X
CA95016143363LP0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPediatrics
No163WP0200XNursing Service ProvidersRegistered NursePediatrics