Provider Demographics
NPI:1003671785
Name:JAIPRAKASH, LAKSHMI
Entity Type:Individual
Prefix:
First Name:LAKSHMI
Middle Name:
Last Name:JAIPRAKASH
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:385 RIVER OAKS PKWY APT 5096
Mailing Address - Street 2:
Mailing Address - City:SAN JOSE
Mailing Address - State:CA
Mailing Address - Zip Code:95134-3492
Mailing Address - Country:US
Mailing Address - Phone:718-406-4208
Mailing Address - Fax:
Practice Address - Street 1:4100 MOORPARK AVE STE 120
Practice Address - Street 2:
Practice Address - City:SAN JOSE
Practice Address - State:CA
Practice Address - Zip Code:95117-1707
Practice Address - Country:US
Practice Address - Phone:408-320-5960
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-02-21
Last Update Date:2024-02-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health