=====================================================
General NPI Number Information
=====================================================
NPI Number | 1316483548
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | THERAPY FOR HAPPINESS
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 01/11/2017
-----------------------------------------------------
Last Update Date | 01/11/2017
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 3015 HOPYARD RD SUITE O
-----------------------------------------------------
City | PLEASANTON
-----------------------------------------------------
State | CA
-----------------------------------------------------
Zip | 94588-5247
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 408-916-3490
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | PO BOX 15156
-----------------------------------------------------
City | FREMONT
-----------------------------------------------------
State | CA
-----------------------------------------------------
Zip | 94539-2256
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 408-916-3490
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | OWNER
-----------------------------------------------------
Name | MR. SURINDER HARISH
-----------------------------------------------------
Credential | LMFT
-----------------------------------------------------
Telephone | 408-916-3490
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 106H00000X
-----------------------------------------------------
Taxonomy Name | Marriage & Family Therapist
-----------------------------------------------------
License Number | 80118
-----------------------------------------------------
License Number State | CA
-----------------------------------------------------