Provider Demographics
NPI:1326125014
Name:BABRAH, PRITAM K (PSYD)
Entity Type:Individual
Prefix:MRS
First Name:PRITAM
Middle Name:K
Last Name:BABRAH
Suffix:
Gender:F
Credentials:PSYD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9328 ELK GROVE BLVD.
Mailing Address - Street 2:STE. 195
Mailing Address - City:ELK GROVE
Mailing Address - State:CA
Mailing Address - Zip Code:95624
Mailing Address - Country:US
Mailing Address - Phone:916-686-5555
Mailing Address - Fax:855-554-1456
Practice Address - Street 1:9245 LAGUNA SPRINGS DRIVE
Practice Address - Street 2:SUITE 200
Practice Address - City:ELK GROVE
Practice Address - State:CA
Practice Address - Zip Code:95758
Practice Address - Country:US
Practice Address - Phone:916-686-5555
Practice Address - Fax:855-554-1456
Is Sole Proprietor?:Yes
Enumeration Date:2006-11-01
Last Update Date:2023-06-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAPSY23254103TC0700X, 101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
No103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical