Provider Demographics
NPI:1457672933
Name:PRASAD, SELVEEN
Entity Type:Individual
Prefix:MR
First Name:SELVEEN
Middle Name:
Last Name:PRASAD
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:SHELVEN
Other - Middle Name:
Other - Last Name:PRASAD
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:9057 PARK MEADOWS DR
Mailing Address - Street 2:
Mailing Address - City:ELK GROVE
Mailing Address - State:CA
Mailing Address - Zip Code:95624-2738
Mailing Address - Country:US
Mailing Address - Phone:916-685-1280
Mailing Address - Fax:
Practice Address - Street 1:4441 AUBURN BLVD
Practice Address - Street 2:SUITE E
Practice Address - City:SACRAMENTO
Practice Address - State:CA
Practice Address - Zip Code:95841-4139
Practice Address - Country:US
Practice Address - Phone:916-473-5764
Practice Address - Fax:916-473-5766
Is Sole Proprietor?:No
Enumeration Date:2010-06-18
Last Update Date:2010-06-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst