Healthcare Provider Details

I. General information

NPI: 1912498866
Provider Name (Legal Business Name): MRS. MANJU DEVI DINDYAL
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: MISS MANJU DEVI

II. Dates (important events)

Enumeration Date: 05/27/2018
Last Update Date: 09/09/2026
Certification Date: 09/09/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2829 WATT AVE STE 200
SACRAMENTO CA
95821-6245
US

IV. Provider business mailing address

7674 DARLA WAY
SACRAMENTO CA
95828-5611
US

V. Phone/Fax

Practice location:
  • Phone: 916-418-0828
  • Fax:
Mailing address:
  • Phone: 916-708-5253
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License NumberASW137504
License Number StateCA
# 2
Primary TaxonomyN
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number
License Number StateCA
# 3
Primary TaxonomyN
Taxonomy Code106S00000X
TaxonomyBehavior Technician
License Number
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: