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General NPI Number Information
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NPI Number | 1386299014
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Entity Type | Individual
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Provider Name | SHIVANI PRASANNA DONGRE
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Gender | Female
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Dates
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Enumeration Date | 08/08/2019
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Last Update Date | 08/08/2019
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Provider Practice Location Address
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Address Line | 617 BAYONET CIR
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City | MARINA
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State | CA
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Zip | 93933-4600
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Country | US
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Telephone | 831-649-4522
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Fax |
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Provider Business Mailing Address
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Address Line | 1975 MILITARY AVE
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City | SEASIDE
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State | CA
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Zip | 93955-3414
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Country | US
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Telephone | 443-517-8462
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101YM0800X
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Taxonomy Name | Mental Health Counselor
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License Number | 6787
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License Number State | CA
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