Provider Demographics
NPI:1982878203
Name:SHETH, PALLAVI PARTHASARATHY (RN, CPNP)
Entity Type:Individual
Prefix:MS
First Name:PALLAVI
Middle Name:PARTHASARATHY
Last Name:SHETH
Suffix:
Gender:F
Credentials:RN, CPNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:455 8TH AVE APT 3
Mailing Address - Street 2:
Mailing Address - City:SAN FRANCISCO
Mailing Address - State:CA
Mailing Address - Zip Code:94118-3070
Mailing Address - Country:US
Mailing Address - Phone:925-408-8557
Mailing Address - Fax:
Practice Address - Street 1:4180 PARK BLVD
Practice Address - Street 2:
Practice Address - City:OAKLAND
Practice Address - State:CA
Practice Address - Zip Code:94602-1207
Practice Address - Country:US
Practice Address - Phone:510-530-5437
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2008-04-17
Last Update Date:2011-12-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CANP 18081363LP0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPediatrics