Individual
ILLISHA KAUR DUNLEAVY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
FNP
Contact information
Practice address
2371 OWEN ST, SANTA CLARA, CA 95054-3212
(408) 708-0204
Mailing address
5980 CHARLOTTE DR, SAN JOSE, CA 95123-6809
(408) 507-8124
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
95019654
CA
Other
Enumeration date
01/11/2022
Last updated
01/11/2022
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