MEDICARE: KAUSHAL VIKRANTH SINGH

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	106S00000X	Behavior Technician	Y3815654	CA

General Provider Information

NPI Number	:	1093275604
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	KAUSHAL VIKRANTH SINGH

Provider Business Mailing Address
First Line	:	36163 FREMONT BLVD APT 61
Second Line	:
City	:	FREMONT
State	:	CA
Zip	:	94536-3553
Country	:	US
Telephone Number	:	510-600-4981
Fax Number	:

Provider Business Practice Location Address
First Line	:	39210 STATE ST STE 100
Second Line	:
City	:	FREMONT
State	:	CA
Zip	:	94538-1456
Country	:	US
Telephone Number	:	818-345-2345
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	03/20/2019
Last Update Date	:	03/20/2019

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