Provider Demographics
NPI:1811031305
Name:KHETRAPAL, TARA FINDLAY (MA)
Entity Type:Individual
Prefix:MRS
First Name:TARA
Middle Name:FINDLAY
Last Name:KHETRAPAL
Suffix:
Gender:F
Credentials:MA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:890 LEWIS AVE
Mailing Address - Street 2:
Mailing Address - City:SUNNYVALE
Mailing Address - State:CA
Mailing Address - Zip Code:94086-5914
Mailing Address - Country:US
Mailing Address - Phone:408-306-6034
Mailing Address - Fax:
Practice Address - Street 1:2894 HOMESTEAD RD
Practice Address - Street 2:
Practice Address - City:SANTA CLARA
Practice Address - State:CA
Practice Address - Zip Code:95051-5224
Practice Address - Country:US
Practice Address - Phone:408-553-6905
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-02-16
Last Update Date:2021-12-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAAU 2045231H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes231H00000XSpeech, Language and Hearing Service ProvidersAudiologist
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAHA 4056OtherHEARING AID LICENSE
CAAU 2045OtherAUDIOLOGY LICENSE