Provider Demographics
NPI:1326560822
Name:KASHINATH, THRISHA (PA-C)
Entity Type:Individual
Prefix:MRS
First Name:THRISHA
Middle Name:
Last Name:KASHINATH
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:451 5TH MAIN 8TH CROSS HIG-DOLLARS COLONY RMV 2ND STAGE
Mailing Address - Street 2:
Mailing Address - City:BANGALORE
Mailing Address - State:KARNATAKA
Mailing Address - Zip Code:560094
Mailing Address - Country:IN
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:1335 STANFORD AVE
Practice Address - Street 2:
Practice Address - City:EMERYVILLE
Practice Address - State:CA
Practice Address - Zip Code:94608-2536
Practice Address - Country:US
Practice Address - Phone:510-647-5101
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2017-07-17
Last Update Date:2018-03-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAPA18998363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantGroup - Multi-Specialty