Provider Demographics
NPI:1861164915
Name:DUTTA, SHILPA (MPH)
Entity type:Individual
Prefix:
First Name:SHILPA
Middle Name:
Last Name:DUTTA
Suffix:
Gender:F
Credentials:MPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1096 AILEEN ST APT B
Mailing Address - Street 2:
Mailing Address - City:OAKLAND
Mailing Address - State:CA
Mailing Address - Zip Code:94608-2772
Mailing Address - Country:US
Mailing Address - Phone:732-979-7459
Mailing Address - Fax:
Practice Address - Street 1:1096 AILEEN ST APT B
Practice Address - Street 2:
Practice Address - City:OAKLAND
Practice Address - State:CA
Practice Address - Zip Code:94608-2772
Practice Address - Country:US
Practice Address - Phone:732-979-7459
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-09-28
Last Update Date:2023-07-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA374J00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374J00000XNursing Service Related ProvidersDoula