Individual
SHALISA ETI
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
3311 KIFER RD, SANTA CLARA, CA 95051-0708
(408) 730-6905
Mailing address
163 SWEETBERRY CT, SAN JOSE, CA 95136-2429
(408) 564-3218
Taxonomy
Speciality
Code
Description
License number
State
175T00000X
Peer Specialist
Primary
—
—
Other
Enumeration date
08/06/2026
Last updated
08/06/2026
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