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NPI Code Detail

MEDICARE: KAVYA BALAJI

MEDICARE: KAVYA BALAJI
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
1103K00000XBehavior Analyst

General Provider Information

NPI Number : 1437811296
Entity Type Code : Individual
Provider Name (Legal Business Name) : KAVYA BALAJI
Provider Business Mailing Address
First Line : 5235 FIORE TER APT C206
Second Line :
City : SAN DIEGO
State : CA
Zip : 92122-6513
Country : US
Telephone Number : 408-859-7724
Fax Number :
Provider Business Practice Location Address
First Line : 3550 CAMINO DEL RIO N
Second Line :
City : SAN DIEGO
State : CA
Zip : 92108-1737
Country : US
Telephone Number : 760-634-1125
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 10/08/2021
Last Update Date : 10/08/2021

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Directions to “ KAVYA BALAJI ” Practice Location

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