Healthcare Provider Details

I. General information

NPI: 1891928149
Provider Name (Legal Business Name): MISS LALITHA ACHARYA
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/02/2009
Last Update Date: 09/02/2009
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2400 MOORPARK AVE SUIT 300
SAN JOSE CA
95128
US

IV. Provider business mailing address

1873 S SPRINGER RD UNIT A
MOUNTAIN VIEW CA
94040-4052
US

V. Phone/Fax

Practice location:
  • Phone: 408-975-2730
  • Fax:
Mailing address:
  • Phone: 310-245-3220
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: