Healthcare Provider Details

I. General information

NPI: 1740197086
Provider Name (Legal Business Name): TANVI BELLAMKONDA
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/24/2026
Last Update Date: 08/24/2026
Certification Date: 08/24/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

14583 BIG BASIN WAY STE 2B
SARATOGA CA
95070-6072
US

IV. Provider business mailing address

359 CATAMARAN ST
FOSTER CITY CA
94404-2907
US

V. Phone/Fax

Practice location:
  • Phone: 831-917-5510
  • Fax:
Mailing address:
  • Phone: 650-483-4319
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code106H00000X
TaxonomyMarriage & Family Therapist
License Number
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: