Basic Information
Provider Information
NPI: 1013222744
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: SHUJAAT
FirstName: FAUZIA
MiddleName:  
NamePrefix: DR.
NameSuffix:  
Credential: MD
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 490 POST ST STE 1043
Address2:  
City: SAN FRANCISCO
State: CA
PostalCode: 941021301
CountryCode: US
TelephoneNumber:  
FaxNumber:  
Practice Location
Address1: 490 POST ST STE 1043
Address2:  
City: SAN FRANCISCO
State: CA
PostalCode: 941021301
CountryCode: US
TelephoneNumber: 4152965290
FaxNumber:  
Other Information
ProviderEnumerationDate: 08/18/2010
LastUpdateDate: 08/26/2014
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: F
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
2084P0800XA113562CAY Allopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry

No ID Information.


Home