Healthcare Provider Details

I. General information

NPI: 1508668328
Provider Name (Legal Business Name): NIYATI N SHETH M.A.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: NIYATI A GANDHI M.A.

II. Dates (important events)

Enumeration Date: 03/24/2025
Last Update Date: 04/14/2025
Certification Date: 04/14/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

800 W EL CAMINO REAL STE 180
MOUNTAIN VIEW CA
94040-2586
US

IV. Provider business mailing address

800 W EL CAMINO REAL STE 180
MOUNTAIN VIEW CA
94040-2586
US

V. Phone/Fax

Practice location:
  • Phone: 437-998-2879
  • Fax:
Mailing address:
  • Phone: 437-998-2879
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number15561
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: