Provider Demographics
NPI:1558425793
Name:MAHENDRU, PUNIT (PHD)
Entity Type:Individual
Prefix:DR
First Name:PUNIT
Middle Name:
Last Name:MAHENDRU
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:46925 ZAPOTEC DR
Mailing Address - Street 2:
Mailing Address - City:FREMONT
Mailing Address - State:CA
Mailing Address - Zip Code:94539-7212
Mailing Address - Country:US
Mailing Address - Phone:408-871-5815
Mailing Address - Fax:408-871-5825
Practice Address - Street 1:200 E HACIENDA AVE
Practice Address - Street 2:
Practice Address - City:CAMPBELL
Practice Address - State:CA
Practice Address - Zip Code:95008-6617
Practice Address - Country:US
Practice Address - Phone:408-871-5815
Practice Address - Fax:408-871-5825
Is Sole Proprietor?:No
Enumeration Date:2006-12-21
Last Update Date:2021-12-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA16043103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist