MEDICARE: MRS. MANJU DEVI DINDYAL

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	106S00000X	Behavior Technician		CA
2	390200000X	Student in an Organized Health Care Education/Training Program		CA

General Provider Information

NPI Number	:	1912498866
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MRS. MANJU DEVI DINDYAL

Provider Business Mailing Address
First Line	:	7674 DARLA WAY
Second Line	:
City	:	SACRAMENTO
State	:	CA
Zip	:	95828-5611
Country	:	US
Telephone Number	:	916-708-5253
Fax Number	:

Provider Business Practice Location Address
First Line	:	7674 DARLA WAY
Second Line	:
City	:	SACRAMENTO
State	:	CA
Zip	:	95828-5611
Country	:	US
Telephone Number	:	916-708-5253
Fax Number	:

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

Provider Enumeration Date	:	05/27/2018
Last Update Date	:	05/21/2025

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