Provider Demographics
NPI:1235994260
Name:CHAMBERLIN, EMILY R
Entity type:Individual
Prefix:
First Name:EMILY
Middle Name:R
Last Name:CHAMBERLIN
Suffix:
Gender:
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2324 SANTA RITA RD STE 2
Mailing Address - Street 2:
Mailing Address - City:PLEASANTON
Mailing Address - State:CA
Mailing Address - Zip Code:94566-4150
Mailing Address - Country:US
Mailing Address - Phone:408-500-7462
Mailing Address - Fax:
Practice Address - Street 1:280 KRISMER ST
Practice Address - Street 2:
Practice Address - City:MILPITAS
Practice Address - State:CA
Practice Address - Zip Code:95035-4821
Practice Address - Country:US
Practice Address - Phone:408-500-7462
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-02-19
Last Update Date:2025-04-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA95028929363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner