Provider Demographics
NPI:1477941219
Name:NAKSHATRI, PRASHANT
Entity Type:Individual
Prefix:
First Name:PRASHANT
Middle Name:
Last Name:NAKSHATRI
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:C/O K.G.NAKSHATRI, VASUKI, AMBALPADY POST
Mailing Address - Street 2:UDUPI DIST, KARNATAKA AND INDIA
Mailing Address - City:UDUPI
Mailing Address - State:KARNATAKA
Mailing Address - Zip Code:576116
Mailing Address - Country:IN
Mailing Address - Phone:091-948-2044
Mailing Address - Fax:012-345-6789
Practice Address - Street 1:1035 W BEVERLY BLVD
Practice Address - Street 2:
Practice Address - City:MONTEBELLO
Practice Address - State:CA
Practice Address - Zip Code:90640-4138
Practice Address - Country:US
Practice Address - Phone:323-724-1315
Practice Address - Fax:323-724-1053
Is Sole Proprietor?:Yes
Enumeration Date:2015-01-01
Last Update Date:2015-01-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA16192235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist