Healthcare Provider Details

I. General information

NPI: 1346842119
Provider Name (Legal Business Name): KEERAT SIDHU BHATTI M.A., M.PHIL., M.S.C
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: KEERAT SIDHU M.A., M.PHIL.

II. Dates (important events)

Enumeration Date: 11/16/2020
Last Update Date: 10/31/2024
Certification Date: 10/31/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2400 MOORPARK AVE., SUITE 300
SAN JOSE CA
95128
US

IV. Provider business mailing address

2400 MOORPARK AVE., SUITE 300
SAN JOSE CA
95128
US

V. Phone/Fax

Practice location:
  • Phone: 408-975-2730
  • Fax: 415-554-0159
Mailing address:
  • Phone: 415-762-3700
  • Fax: 415-554-0159

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code103T00000X
TaxonomyPsychologist
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: