Healthcare Provider Details

I. General information

NPI: 1851121511
Provider Name (Legal Business Name): TAMNNA KUMARI BHARGAV
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/06/2024
Last Update Date: 05/07/2025
Certification Date: 05/07/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3727 SUNSET LN STE 210
ANTIOCH CA
94509-6135
US

IV. Provider business mailing address

3727 SUNSET LN STE 210
ANTIOCH CA
94509-6135
US

V. Phone/Fax

Practice location:
  • Phone: 925-753-2156
  • Fax:
Mailing address:
  • Phone: 925-753-2156
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code373H00000X
TaxonomyDay Training/Habilitation Specialist
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: