Healthcare Provider Details

I. General information

NPI: 1962631432
Provider Name (Legal Business Name): VANEETA SANDHU M.A.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/06/2009
Last Update Date: 09/26/2012
Certification Date:
Deactivation Date: 08/14/2012
Reactivation Date: 09/26/2012

III. Provider practice location address

1001 POTRERO AVE 7TH FLOOR
SAN FRANCISCO CA
94110-3518
US

IV. Provider business mailing address

1001 POTRERO AVE 7TH FLOOR
SAN FRANCISCO CA
94110-3518
US

V. Phone/Fax

Practice location:
  • Phone: 415-206-8403
  • Fax:
Mailing address:
  • Phone: 415-206-8403
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: