Provider Demographics
NPI:1710350640
Name:HARITHA RAJU
Entity Type:Organization
Organization Name:HARITHA RAJU
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PSYCHOLOGICAL ASSISTANT
Authorized Official - Prefix:DR
Authorized Official - First Name:HARITHA
Authorized Official - Middle Name:
Authorized Official - Last Name:RAJU
Authorized Official - Suffix:
Authorized Official - Credentials:PHD
Authorized Official - Phone:925-428-7689
Mailing Address - Street 1:5809 MAYMONT LN
Mailing Address - Street 2:
Mailing Address - City:DUBLIN
Mailing Address - State:CA
Mailing Address - Zip Code:94568-7301
Mailing Address - Country:US
Mailing Address - Phone:925-428-7689
Mailing Address - Fax:
Practice Address - Street 1:1525 MCCARTHY BLVD
Practice Address - Street 2:
Practice Address - City:MILPITAS
Practice Address - State:CA
Practice Address - Zip Code:95035-7451
Practice Address - Country:US
Practice Address - Phone:925-428-7689
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-10-30
Last Update Date:2015-10-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAPSB94021470251V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251V00000XAgenciesVoluntary or Charitable