Provider Demographics
NPI:1467236299
Name:MAKADIA, DUSHYANT (PHD)
Entity Type:Individual
Prefix:DR
First Name:DUSHYANT
Middle Name:
Last Name:MAKADIA
Suffix:
Gender:M
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6270 VAN BUREN BLVD
Mailing Address - Street 2:
Mailing Address - City:RIVERSIDE
Mailing Address - State:CA
Mailing Address - Zip Code:92503-2024
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:402 W BROADWAY STE 1925
Practice Address - Street 2:
Practice Address - City:SAN DIEGO
Practice Address - State:CA
Practice Address - Zip Code:92101-8505
Practice Address - Country:US
Practice Address - Phone:619-930-9060
Practice Address - Fax:619-930-9060
Is Sole Proprietor?:No
Enumeration Date:2023-08-22
Last Update Date:2024-03-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist