Healthcare Provider Details

I. General information

NPI: 1881842151
Provider Name (Legal Business Name): MANISHA CHATURVEDI KENT PSY.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/28/2008
Last Update Date: 06/16/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2425 BISSO LN STE 200
CONCORD CA
94520-4886
US

IV. Provider business mailing address

2425 BISSO LANE STE 200
CONCORD CA
94520
US

V. Phone/Fax

Practice location:
  • Phone: 925-521-5780
  • Fax:
Mailing address:
  • Phone: 510-629-6300
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103TC0700X
TaxonomyClinical Psychologist
License NumberPSY25734
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: