Healthcare Provider Details

I. General information

NPI: 1053726281
Provider Name (Legal Business Name): ROHINI PURI
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/26/2014
Last Update Date: 06/26/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2222 BANCROFT WAY UHS TANG CENTER
BERKELEY CA
94720-4300
US

IV. Provider business mailing address

2222 BANCROFT WAY UHS TANG CENTER
BERKELEY CA
94720-4300
US

V. Phone/Fax

Practice location:
  • Phone: 510-642-2000
  • Fax:
Mailing address:
  • Phone: 510-642-2000
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103TC1900X
TaxonomyCounseling Psychologist
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: