Provider Demographics
NPI:1528741014
Name:VAKHARIA, BHOOMIKA (FNP)
Entity type:Individual
Prefix:MRS
First Name:BHOOMIKA
Middle Name:
Last Name:VAKHARIA
Suffix:
Gender:F
Credentials:FNP
Other - Prefix:MRS
Other - First Name:BHOOMIKA
Other - Middle Name:
Other - Last Name:NAKRANI
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:5644 MISSION CENTER RD
Mailing Address - Street 2:
Mailing Address - City:SAN DIEGO
Mailing Address - State:CA
Mailing Address - Zip Code:92108-4328
Mailing Address - Country:US
Mailing Address - Phone:619-298-3655
Mailing Address - Fax:
Practice Address - Street 1:5644 MISSION CENTER RD
Practice Address - Street 2:
Practice Address - City:SAN DIEGO
Practice Address - State:CA
Practice Address - Zip Code:92108-4328
Practice Address - Country:US
Practice Address - Phone:619-298-3655
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-08-10
Last Update Date:2024-04-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA95026715363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamilyGroup - Single Specialty