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General NPI Number Information
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NPI Number | 1619344199
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Entity Type | Individual
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Provider Name | MEENAL CHAUDHARI
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Gender | Female
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Dates
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Enumeration Date | 08/31/2015
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Last Update Date | 08/31/2015
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Provider Practice Location Address
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Address Line | 400 CARLTON AVE SUITE 1
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City | LOS GATOS
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State | CA
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Zip | 95032-2629
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Country | US
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Telephone | 831-246-0069
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 3164
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City | SANTA CRUZ
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State | CA
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Zip | 95063-3164
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Country | US
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Telephone | 831-246-0069
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Fax | 844-321-7559
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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 | 106H00000X
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Taxonomy Name | Marriage & Family Therapist
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License Number | IMF 75020
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License Number State | CA
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