Healthcare Provider Details
I. General information
NPI: 1346389145
Provider Name (Legal Business Name): BHUPINDER WARAICH MD, INC
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 02/06/2007
Last Update Date: 09/11/2025
Certification Date:
Deactivation Date:
Reactivation Date:
III. Provider practice location address
5674 STONERIDGE DR SUITE 116
PLEASANTON CA
94588-8500
US
IV. Provider business mailing address
5674 STONERIDGE DR SUITE 116
PLEASANTON CA
94588-8500
US
V. Phone/Fax
- Phone: 925-520-0005
- Fax: 925-520-0010
- Phone: 925-520-0005
- Fax: 925-520-0010
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | N |
| Taxonomy Code | 103T00000X |
| Taxonomy | Psychologist |
| License Number | A53968 |
| License Number State | CA |
| # 2 | |
| Primary Taxonomy | N |
| Taxonomy Code | 106H00000X |
| Taxonomy | Marriage & Family Therapist |
| License Number | A53968 |
| License Number State | CA |
| # 3 | |
| Primary Taxonomy | N |
| Taxonomy Code | 101YM0800X |
| Taxonomy | Mental Health Counselor |
| License Number | A53968 |
| License Number State | CA |
| # 4 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 103TM1800X |
| Taxonomy | Intellectual & Developmental Disabilities Psychologist |
| License Number | A53968 |
| License Number State | CA |
VIII. Authorized Official
Name: MRS.
NEISHA
BECTON
Title or Position: CEO
Credential:
Phone: 925-520-0005