Provider Demographics
NPI:1386668820
Name:HARICHANDRAN, DHARMINI (MD)
Entity Type:Individual
Prefix:DR
First Name:DHARMINI
Middle Name:
Last Name:HARICHANDRAN
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:39 QUAIL CT STE 204
Mailing Address - Street 2:
Mailing Address - City:WALNUT CREEK
Mailing Address - State:CA
Mailing Address - Zip Code:94596-5569
Mailing Address - Country:US
Mailing Address - Phone:925-944-1154
Mailing Address - Fax:925-472-0254
Practice Address - Street 1:39 QUAIL CT STE 204
Practice Address - Street 2:
Practice Address - City:WALNUT CREEK
Practice Address - State:CA
Practice Address - Zip Code:94596-5569
Practice Address - Country:US
Practice Address - Phone:925-944-1154
Practice Address - Fax:925-472-0254
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-27
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA00A4087502084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA5890423Medicaid
CA5890423Medicaid
CAF08845Medicare UPIN