Provider Demographics
NPI:1699844555
Name:PADMANABHAN, SANDHYA (SPEECH LANGUAGE PATH)
Entity Type:Individual
Prefix:MS
First Name:SANDHYA
Middle Name:
Last Name:PADMANABHAN
Suffix:
Gender:F
Credentials:SPEECH LANGUAGE PATH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:632 W 11TH ST STE 119
Mailing Address - Street 2:
Mailing Address - City:TRACY
Mailing Address - State:CA
Mailing Address - Zip Code:95376-3860
Mailing Address - Country:US
Mailing Address - Phone:925-470-6948
Mailing Address - Fax:
Practice Address - Street 1:1811 SANTA RITA RD STE 112
Practice Address - Street 2:
Practice Address - City:PLEASANTON
Practice Address - State:CA
Practice Address - Zip Code:94566-4741
Practice Address - Country:US
Practice Address - Phone:925-470-6948
Practice Address - Fax:925-470-6948
Is Sole Proprietor?:No
Enumeration Date:2006-11-07
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CASP13296235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist