Provider Demographics
NPI:1740599836
Name:BHAKTA, PRAGNA (MS, CCC-SLP)
Entity Type:Individual
Prefix:
First Name:PRAGNA
Middle Name:
Last Name:BHAKTA
Suffix:
Gender:F
Credentials:MS, CCC-SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3954 ALLA RD
Mailing Address - Street 2:
Mailing Address - City:LOS ANGELES
Mailing Address - State:CA
Mailing Address - Zip Code:90066-4114
Mailing Address - Country:US
Mailing Address - Phone:213-268-2053
Mailing Address - Fax:
Practice Address - Street 1:3954 ALLA RD
Practice Address - Street 2:
Practice Address - City:LOS ANGELES
Practice Address - State:CA
Practice Address - Zip Code:90066-4114
Practice Address - Country:US
Practice Address - Phone:213-268-2053
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-10-07
Last Update Date:2010-10-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA12205235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist