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General NPI Number Information
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NPI Number | 1619821329
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Entity Type | Individual
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Provider Name | DIMITRA CHARISI
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Gender | Female
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Dates
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Enumeration Date | 02/21/2026
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Last Update Date | 02/21/2026
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Provider Practice Location Address
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Address Line | 945 FOXCHASE DR APT 519
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City | SAN JOSE
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State | CA
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Zip | 95123-1173
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Country | US
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Telephone | 408-917-0311
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Fax |
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Provider Business Mailing Address
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Address Line | 945 FOXCHASE DR APT 519
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City | SAN JOSE
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State | CA
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Zip | 95123-1173
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Country | US
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Telephone | 408-917-0311
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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 | 103K00000X
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Taxonomy Name | Behavior Analyst
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License Number |
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License Number State | CA
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