Individual
ANITA G SHAH
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
N.P.
Contact information
Practice address
1901 4TH ST STE 201, BERKELEY, CA 94710-1986
(510) 929-1400
(510) 929-1414
Mailing address
PO BOX 511250, LOS ANGELES, CA 90051-7805
(510) 929-1400
(510) 929-1414
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
95037688
CA
363LF0000X
Family Nurse Practitioner
APN.0993293-NP
CO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
12291622
CAQH
—
Enumeration date
08/15/2011
Last updated
03/09/2026
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