Provider Demographics
NPI:1609805894
Name:KALYANI, CHANDRIKA (PHD)
Entity Type:Individual
Prefix:
First Name:CHANDRIKA
Middle Name:
Last Name:KALYANI
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 1:6001 TRUXTUN AVE
Mailing Address - Street 2:SUITE 160
Mailing Address - City:BAKERSFIELD
Mailing Address - State:CA
Mailing Address - Zip Code:93309-0679
Mailing Address - Country:US
Mailing Address - Phone:661-323-6410
Mailing Address - Fax:661-633-3944
Practice Address - Street 1:6001 TRUXTUN AVE
Practice Address - Street 2:SUITE 160
Practice Address - City:BAKERSFIELD
Practice Address - State:CA
Practice Address - Zip Code:93309-0679
Practice Address - Country:US
Practice Address - Phone:661-323-6410
Practice Address - Fax:661-633-3944
Is Sole Proprietor?:No
Enumeration Date:2006-07-01
Last Update Date:2012-03-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAPSY13222103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAFU556ZMedicare PIN