Provider Demographics
NPI:1003240896
Name:NAGI, BALJIT DHANJAL (ASW)
Entity Type:Individual
Prefix:MRS
First Name:BALJIT
Middle Name:DHANJAL
Last Name:NAGI
Suffix:
Gender:F
Credentials:ASW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1659 SCOTT BLVD STE 30
Mailing Address - Street 2:
Mailing Address - City:SANTA CLARA
Mailing Address - State:CA
Mailing Address - Zip Code:95050-4137
Mailing Address - Country:US
Mailing Address - Phone:140-824-4183
Mailing Address - Fax:
Practice Address - Street 1:1659 SCOTT BLVD STE 30
Practice Address - Street 2:
Practice Address - City:SANTA CLARA
Practice Address - State:CA
Practice Address - Zip Code:95050-4137
Practice Address - Country:US
Practice Address - Phone:140-824-4183
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2013-08-28
Last Update Date:2013-08-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAASW229201041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical