Individual
CORNELIA TJANDRA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
FNP
Contact information
Practice address
3300 COLLEGE DR BLDG 19, SAN BRUNO, CA 94066-1698
(650) 738-4270
Mailing address
5315 PACIFIC TERRACE CT, CASTRO VALLEY, CA 94552-5539
(510) 876-8110
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
17905
CA
363LF0000X
Family Nurse Practitioner
R196275
MD
Other
Enumeration date
05/05/2008
Last updated
03/08/2023
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