Provider Demographics
NPI:1740752617
Name:LOHAN, JASBIR S
Entity Type:Individual
Prefix:
First Name:JASBIR
Middle Name:S
Last Name:LOHAN
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7172 REGIONAL ST # 356
Mailing Address - Street 2:
Mailing Address - City:DUBLIN
Mailing Address - State:CA
Mailing Address - Zip Code:94568-2324
Mailing Address - Country:US
Mailing Address - Phone:415-525-6057
Mailing Address - Fax:
Practice Address - Street 1:825 SAN ANTONIO RD STE 102
Practice Address - Street 2:
Practice Address - City:PALO ALTO
Practice Address - State:CA
Practice Address - Zip Code:94303-4620
Practice Address - Country:US
Practice Address - Phone:415-525-6057
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-12-17
Last Update Date:2018-12-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist