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General NPI Number Information
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NPI Number | 1700427507
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Entity Type | Individual
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Provider Name | SUDHEERA RANAWEERA PHD, LP
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Gender | Female
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Dates
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Enumeration Date | 10/02/2019
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Last Update Date | 07/14/2025
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Provider Practice Location Address
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Address Line | 1245 S WINCHESTER BLVD STE 110
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City | SAN JOSE
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State | CA
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Zip | 95128-3908
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Country | US
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Telephone | 925-282-1778
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Fax | 415-296-5299
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Provider Business Mailing Address
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Address Line | 1245 S WINCHESTER BLVD STE 110
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City | SAN JOSE
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State | CA
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Zip | 95128-3908
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Country | US
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Telephone | 925-282-1778
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Fax | 415-296-5299
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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 | 103TC0700X
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Taxonomy Name | Clinical Psychologist
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License Number | 35035
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License Number State | CA
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