Individual
KYRA MARIE DOUGHERTY DELAPEDRAJA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PNP
Contact information
Practice address
15400 LOS GATOS BLVD, LOS GATOS, CA 95032-2502
(408) 523-3640
Mailing address
325 DISTEL CIR, LOS ALTOS, CA 94022-1408
(408) 523-3640
Taxonomy
Speciality
Code
Description
License number
State
363LP0200X
Pediatric Nurse Practitioner
Primary
NP95002321
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
22678522
—
CO
Enumeration date
04/30/2009
Last updated
03/04/2020
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