Provider Demographics
NPI:1811402142
Name:SHRUTHI RAJALAKSHMI, UNKNOWN (BCBA)
Entity Type:Individual
Prefix:
First Name:UNKNOWN
Middle Name:
Last Name:SHRUTHI RAJALAKSHMI
Suffix:
Gender:F
Credentials:BCBA
Other - Prefix:
Other - First Name:SHRUTHI
Other - Middle Name:
Other - Last Name:RAJALAKSHMI
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:BCBA
Mailing Address - Street 1:7108 S KANNER HWY
Mailing Address - Street 2:
Mailing Address - City:STUART
Mailing Address - State:FL
Mailing Address - Zip Code:34997-7462
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:95 3RD ST FL 2
Practice Address - Street 2:
Practice Address - City:SAN FRANCISCO
Practice Address - State:CA
Practice Address - Zip Code:94103-3103
Practice Address - Country:US
Practice Address - Phone:855-832-6727
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-12-08
Last Update Date:2022-05-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst