Individual
SMIJA JAYAPRAKASH
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
7210 MURRAY DRIVE, STOCKTON, CA 95201
(209) 373-2800
Mailing address
2460 CANYON LAKES DRIVE, SAN RAMON, CA 94582
(408) 329-0505
Taxonomy
Speciality
Code
Description
License number
State
2080A0000X
Pediatric Adolescent Medicine Physician
Primary
A125663
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
AI25663
CALIFORNIA LICENSE
CA
Enumeration date
07/20/2010
Last updated
10/29/2015
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