Provider Demographics
NPI:1558569400
Name:BHAKTA, DIPTI (MD)
Entity Type:Individual
Prefix:DR
First Name:DIPTI
Middle Name:
Last Name:BHAKTA
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5674 STONERIDGE DR STE 217
Mailing Address - Street 2:
Mailing Address - City:PLEASANTON
Mailing Address - State:CA
Mailing Address - Zip Code:94588-8532
Mailing Address - Country:US
Mailing Address - Phone:925-227-1967
Mailing Address - Fax:
Practice Address - Street 1:5674 STONERIDGE DR STE 217
Practice Address - Street 2:
Practice Address - City:PLEASANTON
Practice Address - State:CA
Practice Address - Zip Code:94588-8532
Practice Address - Country:US
Practice Address - Phone:925-227-1967
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-07-03
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAG811452084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry