Healthcare Provider Details

I. General information

NPI: 1992369292
Provider Name (Legal Business Name): SUNILA MUQADARATI MSN
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 04/23/2019
Last Update Date: 11/15/2022
Certification Date: 11/15/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

9225 N 3RD ST STE 203
PHOENIX AZ
85020-2464
US

IV. Provider business mailing address

3650 MT DIABLO BLVD STE 107
LAFAYETTE CA
94549-3780
US

V. Phone/Fax

Practice location:
  • Phone: 602-632-2983
  • Fax: 480-565-4552
Mailing address:
  • Phone: 510-665-9700
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103TC1900X
TaxonomyCounseling Psychologist
License Number
License Number StateNULL
# 2
Primary TaxonomyN
Taxonomy Code106S00000X
TaxonomyBehavior Technician
License Number
License Number StateNULL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: