Provider Demographics
NPI:1588021455
Name:GANDHI, NATASHA (BCBA, MFT)
Entity Type:Individual
Prefix:MS
First Name:NATASHA
Middle Name:
Last Name:GANDHI
Suffix:
Gender:F
Credentials:BCBA, MFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:16708 HAMPTON CT
Mailing Address - Street 2:
Mailing Address - City:CERRITOS
Mailing Address - State:CA
Mailing Address - Zip Code:90703-1153
Mailing Address - Country:US
Mailing Address - Phone:562-665-6246
Mailing Address - Fax:
Practice Address - Street 1:16708 HAMPTON CT
Practice Address - Street 2:
Practice Address - City:CERRITOS
Practice Address - State:CA
Practice Address - Zip Code:90703-1153
Practice Address - Country:US
Practice Address - Phone:562-665-6246
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-01-24
Last Update Date:2016-01-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CABCBA 1-14-15070103K00000X
CALMFT91425106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst
No106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist