Provider Demographics
NPI:1164268181
Name:SRINIVAS, NEELA (MPH, MBBS, SA-C)
Entity type:Individual
Prefix:DR
First Name:NEELA
Middle Name:
Last Name:SRINIVAS
Suffix:
Gender:F
Credentials:MPH, MBBS, SA-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:19930 OLIVEWOOD ST UNIT C
Mailing Address - Street 2:
Mailing Address - City:CUPERTINO
Mailing Address - State:CA
Mailing Address - Zip Code:95014-6027
Mailing Address - Country:US
Mailing Address - Phone:408-660-0911
Mailing Address - Fax:
Practice Address - Street 1:19930 OLIVEWOOD ST UNIT C
Practice Address - Street 2:
Practice Address - City:CUPERTINO
Practice Address - State:CA
Practice Address - Zip Code:95014-6027
Practice Address - Country:US
Practice Address - Phone:408-660-0911
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-07-09
Last Update Date:2025-04-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
246ZC0007X
CA374J00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374J00000XNursing Service Related ProvidersDoula
No246ZC0007XTechnologists, Technicians & Other Technical Service ProvidersSpecialist/Technologist, OtherSurgical Assistant