| Deja Shari Koenig, NP | |
|
1375 Blossom Hill Rd Ste 49, San Jose, CA 95118-3806 | |
| (408) 645-7073 | |
| Not Available |
| Full Name | Deja Shari Koenig |
|---|---|
| Gender | Female |
| Speciality | Nurse Practitioner |
| Experience | 6 Years |
| Location | 1375 Blossom Hill Rd Ste 49, San Jose, California |
| Accepts Medicare Assignments | Yes. She accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1184264525 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 363LF0000X | Nurse Practitioner - Family | 95013548 (California) | Secondary |
| 363L00000X | Nurse Practitioner | RN282683 (Georgia) | Primary |
| Group Practice Name | Group PECOS PAC ID | No. of Members |
|---|---|---|
| Wellstreet Of Georgia Pc | 7517126279 | 384 |
| Entity Name | Wellstreet Of Georgia Pc |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1235411547 PECOS PAC ID: 7517126279 Enrollment ID: O20120315000603 |
| Entity Name | True North Health Navigation Llc |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1578047536 PECOS PAC ID: 5294960696 Enrollment ID: O20191011002051 |
| Mailing Address | Practice Location Address |
|---|---|
| Deja Shari Koenig, NP 451 Miller Ave, Freeport, NY 11520-6114 Ph: (516) 830-5338 | Deja Shari Koenig, NP 1375 Blossom Hill Rd Ste 49, San Jose, CA 95118-3806 Ph: (408) 645-7073 |
Louise Mary Bruce, FNP Nurse Practitioner Medicare: Medicare Enrolled Practice Location: 1691 The Alameda, San Jose, CA 95126 Phone: 408-287-7526 Fax: 408-971-6963 | |
Jodie Sugiyama, GNP Nurse Practitioner Medicare: Not Enrolled in Medicare Practice Location: 4850 Union Ave, San Jose, CA 95124 Phone: 408-559-5600 | |
Kera Njenga, Nurse Practitioner Medicare: Medicare Enrolled Practice Location: 52 Skytop St Apt 107, San Jose, CA 95134 Phone: 443-827-2023 | |
Laura J Ohara, R.N., P.N.P. Nurse Practitioner Medicare: Not Enrolled in Medicare Practice Location: 2577 Samaritan Drive, Suite 815, San Jose, CA 95124 Phone: 408-358-3573 | |
Julie Dutton, NP Nurse Practitioner Medicare: Medicare Enrolled Practice Location: 4855 Atherton Ave Ste 101, San Jose, CA 95130 Phone: 408-963-2400 Fax: 408-963-2472 | |
Thu Lan T Pham, NP Nurse Practitioner Medicare: Accepting Medicare Assignments Practice Location: 751 S Bascom Ave, San Jose, CA 95128 Phone: 408-885-5000 | |
Jenney Leem Lam, NP Nurse Practitioner Medicare: Not Enrolled in Medicare Practice Location: 200 Jose Figueres Ave Ste 255, San Jose, CA 95116 Phone: 408-223-7474 Fax: 408-223-9339 |