Individual provider · NPI-1

Shanthi Chodagiri

Physician Assistant · Moorpark, CA

NPI number1659935104
StatusActive
Last updated in NPPESMar 13, 2026

Details

NPI
1659935104
Entity type
Individual (NPI-1)
Name
Shanthi Chodagiri
Sex
Female
Sole proprietor
Yes
Enumeration date
Apr 30, 2019
Certification date
Mar 13, 2026
Last updated
Mar 13, 2026

Taxonomy and licenses

Taxonomy codeDescriptionLicenseStatePrimary
363A00000X Physician AssistantPA57319CAYes

Practice location

11529 Treeview Ct
Moorpark, CA 93021-3734

Phone 585-615-5351

Mailing address

11529 Treeview Ct
Moorpark, CA 93021-3734

Phone 585-615-5351

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