MEDICARE: PRIYA MAHURKAR PH.D.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	103TC0700X	Clinical Psychologist	PSY24059	CA

General Provider Information

NPI Number	:	1124302195
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	PRIYA MAHURKAR PH.D.

Provider Business Mailing Address
First Line	:	21760 STEVENS CREEK BLVD STE 102
Second Line	:
City	:	CUPERTINO
State	:	CA
Zip	:	95014-1170
Country	:	US
Telephone Number	:	408-230-4992
Fax Number	:

Provider Business Practice Location Address
First Line	:	21760 STEVENS CREEK BLVD STE 102
Second Line	:
City	:	CUPERTINO
State	:	CA
Zip	:	95014-1170
Country	:	US
Telephone Number	:	408-230-4992
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	10/07/2011
Last Update Date	:	04/29/2026

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