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NPI 1952177255

NPI 1952177255 : REHA PRASAD : ALAMEDA, CA

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General NPI Number Information
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    NPI Number           |    1952177255
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    Entity Type          |    Individual 
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    Provider Name        |    REHA PRASAD
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    Gender               |    Female 
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Dates
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    Enumeration Date     |    11/28/2023
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    Last Update Date     |    11/28/2023
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Provider Practice Location Address
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    Address Line         |    1080 MARINA VILLAGE PKWY 
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    City                 |    ALAMEDA
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    State                |    CA
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    Zip                  |    94501-6427
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    Country              |    US
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    Telephone            |    510-381-0654
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    Fax                  |    
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Provider Business Mailing Address
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    Address Line         |    24438 SANTA CLARA ST #3571 
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    City                 |    HAYWARD
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    State                |    CA
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    Zip                  |    94540-3571
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    Country              |    US
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    Telephone            |    510-329-7541
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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        |    104100000X
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    Taxonomy Name        |    Social Worker
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    License Number       |    119008
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    License Number State |    CA
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