Provider Demographics
NPI:1003084542
Name:MATHUR, ANSHU (MFT INTERN)
Entity Type:Individual
Prefix:MRS
First Name:ANSHU
Middle Name:
Last Name:MATHUR
Suffix:
Gender:F
Credentials:MFT INTERN
Other - Prefix:MRS
Other - First Name:ANSHU
Other - Middle Name:
Other - Last Name:MATHUR
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:2086 COMMERCE AVE
Mailing Address - Street 2:
Mailing Address - City:CONCORD
Mailing Address - State:CA
Mailing Address - Zip Code:94520-4902
Mailing Address - Country:US
Mailing Address - Phone:925-827-0212
Mailing Address - Fax:925-827-1122
Practice Address - Street 1:2086 COMMERCE AVE
Practice Address - Street 2:
Practice Address - City:CONCORD
Practice Address - State:CA
Practice Address - Zip Code:94520-4902
Practice Address - Country:US
Practice Address - Phone:925-827-0212
Practice Address - Fax:925-827-1122
Is Sole Proprietor?:No
Enumeration Date:2008-02-19
Last Update Date:2022-01-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAIMF49534101YM0800X
CAIMF 49534101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health