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General NPI Number Information
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NPI Number | 1881330090
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Entity Type | Individual
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Provider Name | NAINA DEEPAK MAHTANI PSY.D.
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Gender | Female
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Dates
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Enumeration Date | 05/10/2022
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Last Update Date | 05/10/2022
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Provider Practice Location Address
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Address Line | 39400 PASEO PADRE PKWY
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City | FREMONT
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State | CA
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Zip | 94538-2310
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Country | US
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Telephone | 510-248-3000
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Fax |
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Provider Business Mailing Address
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Address Line | 37967 HARBOR LIGHT RD
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City | NEWARK
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State | CA
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Zip | 94560-3492
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Country | US
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Telephone | 818-614-4716
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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 | 103TC0700X
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Taxonomy Name | Clinical Psychologist
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License Number | 33259
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License Number State | CA
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Taxonomy #2
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Taxonomy Code | 103TH0004X
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Taxonomy Name | Health Psychologist
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License Number | 33259
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License Number State | CA
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Taxonomy #3
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Taxonomy Code | 103TB0200X
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Taxonomy Name | Cognitive & Behavioral Psychologist
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License Number | 33259
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License Number State | CA
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