Provider Demographics
NPI:1467827881
Name:ROYCHOUDHURY, SUNITA
Entity Type:Individual
Prefix:
First Name:SUNITA
Middle Name:
Last Name:ROYCHOUDHURY
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 1:1320 ARNOLD DR
Mailing Address - Street 2:#170
Mailing Address - City:MARTINEZ
Mailing Address - State:CA
Mailing Address - Zip Code:94553-6537
Mailing Address - Country:US
Mailing Address - Phone:925-322-1256
Mailing Address - Fax:925-372-4216
Practice Address - Street 1:1320 ARNOLD DR
Practice Address - Street 2:#170
Practice Address - City:MARTINEZ
Practice Address - State:CA
Practice Address - Zip Code:94553-6537
Practice Address - Country:US
Practice Address - Phone:925-372-4213
Practice Address - Fax:925-373-4216
Is Sole Proprietor?:No
Enumeration Date:2015-12-10
Last Update Date:2018-01-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA#1778101YP2500X
CALMFT103569106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist
No101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional