Provider Demographics
NPI:1770033557
Name:SRIDHAR, PRITHI
Entity Type:Individual
Prefix:
First Name:PRITHI
Middle Name:
Last Name:SRIDHAR
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1306 NESTWOOD WAY
Mailing Address - Street 2:
Mailing Address - City:MILPITAS
Mailing Address - State:CA
Mailing Address - Zip Code:95035-9000
Mailing Address - Country:US
Mailing Address - Phone:510-861-2247
Mailing Address - Fax:
Practice Address - Street 1:1306 NESTWOOD WAY
Practice Address - Street 2:
Practice Address - City:MILPITAS
Practice Address - State:CA
Practice Address - Zip Code:95035-9000
Practice Address - Country:US
Practice Address - Phone:510-861-2247
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-10-05
Last Update Date:2017-03-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171M00000XOther Service ProvidersCase Manager/Care Coordinator