Healthcare Provider Details

I. General information

NPI: 1316330558
Provider Name (Legal Business Name): ARCHANA SATHYANARAYANAN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/12/2015
Last Update Date: 07/08/2026
Certification Date: 07/08/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

13 PETER BEHR DR
SAN RAFAEL CA
94903-5216
US

IV. Provider business mailing address

13 PETER BEHR DR
SAN RAFAEL CA
94903-5216
US

V. Phone/Fax

Practice location:
  • Phone: 415-473-6648
  • Fax:
Mailing address:
  • Phone: 415-473-6648
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101Y00000X
TaxonomyCounselor
License Number20956
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: