Provider Demographics
NPI:1073700738
Name:SUDINDRANATH, MANISHA
Entity Type:Individual
Prefix:
First Name:MANISHA
Middle Name:
Last Name:SUDINDRANATH
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 1:1483 SUTTER ST UNIT 1601
Mailing Address - Street 2:
Mailing Address - City:SAN FRANCISCO
Mailing Address - State:CA
Mailing Address - Zip Code:94109-5498
Mailing Address - Country:US
Mailing Address - Phone:415-425-7446
Mailing Address - Fax:
Practice Address - Street 1:2727 MARIPOSA ST
Practice Address - Street 2:STE 101
Practice Address - City:SAN FRANCISCO
Practice Address - State:CA
Practice Address - Zip Code:94110-1472
Practice Address - Country:US
Practice Address - Phone:415-437-3011
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-09-26
Last Update Date:2009-07-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst