Provider Demographics
NPI:1043590748
Name:KAUSHIK, MOHITA (MA CCC-SLP)
Entity Type:Individual
Prefix:MS
First Name:MOHITA
Middle Name:
Last Name:KAUSHIK
Suffix:
Gender:F
Credentials:MA CCC-SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2558 WASHINGTON BLVD
Mailing Address - Street 2:
Mailing Address - City:FREMONT
Mailing Address - State:CA
Mailing Address - Zip Code:94539-5034
Mailing Address - Country:US
Mailing Address - Phone:410-206-4934
Mailing Address - Fax:
Practice Address - Street 1:39420 LIBERTY ST STE 150
Practice Address - Street 2:
Practice Address - City:FREMONT
Practice Address - State:CA
Practice Address - Zip Code:94538-2284
Practice Address - Country:US
Practice Address - Phone:510-794-5155
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2011-08-25
Last Update Date:2021-12-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CASP27004235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist