Provider Demographics
NPI:1154046563
Name:UPADHYAYA, APARNA (NP)
Entity type:Individual
Prefix:
First Name:APARNA
Middle Name:
Last Name:UPADHYAYA
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4222 DEEP CREEK RD
Mailing Address - Street 2:
Mailing Address - City:FREMONT
Mailing Address - State:CA
Mailing Address - Zip Code:94555-2061
Mailing Address - Country:US
Mailing Address - Phone:408-921-6942
Mailing Address - Fax:
Practice Address - Street 1:2970 HILLTOP MALL RD STE 305
Practice Address - Street 2:
Practice Address - City:SAN PABLO
Practice Address - State:CA
Practice Address - Zip Code:94806-5274
Practice Address - Country:US
Practice Address - Phone:510-222-5437
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-10-07
Last Update Date:2022-10-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA1598917247208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208000000XAllopathic & Osteopathic PhysiciansPediatricsGroup - Single Specialty