Active NPI
Sheethal Lukose
- Gerontology Clinical Nurse Specialist
- Fremont, CA
National Provider Identifier
1023870458
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Gerontology Clinical Nurse Specialist
- License
- 3012
- Practice address
- 39400 Paseo Padre Pkwy
Fremont, CA 94538-2310 - Phone
- (510) 248-3000
- NPI assigned
- Jan 30, 2024
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Gerontology Clinical Nurse Specialist | 364SG0600X | 3012 | CA | Primary |
Addresses
Primary practice location
39400 Paseo Padre Pkwy
Fremont, CA 94538-2310
Mailing address
3233 Briggs CT
Fremont, CA 94536-2406
Phone (510) 414-9693
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1706572800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1706572800000",
"number": "1023870458",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3233 BRIGGS CT",
"city": "FREMONT",
"state": "CA",
"postal_code": "945362406",
"telephone_number": "510-414-9693"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "39400 PASEO PADRE PKWY",
"city": "FREMONT",
"state": "CA",
"postal_code": "945382310",
"telephone_number": "510-248-3000"
}
],
"practiceLocations": [],
"basic": {
"last_name": "LUKOSE",
"first_name": "SHEETHAL",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2024-01-30",
"last_updated": "2024-01-30",
"certification_date": "2024-01-30",
"status": "A"
},
"taxonomies": [
{
"code": "364SG0600X",
"taxonomy_group": "",
"desc": "Clinical Nurse Specialist, Gerontology",
"state": "CA",
"license": "3012",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Fremont, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 30, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.