Provider Demographics
NPI:1437989688
Name:KHAHERA, CHARANJEET
Entity type:Individual
Prefix:
First Name:CHARANJEET
Middle Name:
Last Name:KHAHERA
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 1:1060 REGATTA PT
Mailing Address - Street 2:
Mailing Address - City:HERCULES
Mailing Address - State:CA
Mailing Address - Zip Code:94547-2603
Mailing Address - Country:US
Mailing Address - Phone:510-520-3816
Mailing Address - Fax:
Practice Address - Street 1:1451 28TH AVE
Practice Address - Street 2:
Practice Address - City:OAKLAND
Practice Address - State:CA
Practice Address - Zip Code:94601-1632
Practice Address - Country:US
Practice Address - Phone:510-261-9191
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-08-02
Last Update Date:2024-08-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA457187163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse