Provider Demographics
NPI:1699219501
Name:NANDAN, JOYTISHNA NANDANI (MA)
Entity Type:Individual
Prefix:MS
First Name:JOYTISHNA
Middle Name:NANDANI
Last Name:NANDAN
Suffix:
Gender:F
Credentials:MA
Other - Prefix:MS
Other - First Name:JOYTISHNA
Other - Middle Name:
Other - Last Name:NANDAN
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:MA
Mailing Address - Street 1:18225 HALE AVE
Mailing Address - Street 2:
Mailing Address - City:MORGAN HILL
Mailing Address - State:CA
Mailing Address - Zip Code:95037-3547
Mailing Address - Country:US
Mailing Address - Phone:916-457-3129
Mailing Address - Fax:
Practice Address - Street 1:9343 TECH CENTER DR STE 110
Practice Address - Street 2:
Practice Address - City:SACRAMENTO
Practice Address - State:CA
Practice Address - Zip Code:95826-2592
Practice Address - Country:US
Practice Address - Phone:916-457-3129
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-12-12
Last Update Date:2023-11-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA101Y00000X, 390200000X
CA3659101YM0800X
CA13778101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
No101Y00000XBehavioral Health & Social Service ProvidersCounselor
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program