Provider Demographics
NPI:1356867667
Name:KAVI, NEETA
Entity Type:Individual
Prefix:
First Name:NEETA
Middle Name:
Last Name:KAVI
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 1:6564 FIFEWOOD CT
Mailing Address - Street 2:
Mailing Address - City:SAN JOSE
Mailing Address - State:CA
Mailing Address - Zip Code:95120-1913
Mailing Address - Country:US
Mailing Address - Phone:408-306-6845
Mailing Address - Fax:
Practice Address - Street 1:6564 FIFEWOOD CT
Practice Address - Street 2:
Practice Address - City:SAN JOSE
Practice Address - State:CA
Practice Address - Zip Code:95120-1913
Practice Address - Country:US
Practice Address - Phone:408-306-6845
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2017-08-17
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YS0200XBehavioral Health & Social Service ProvidersCounselorSchool
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAD8235279OtherDRIVER LICENSE