Provider Demographics
NPI:1841602596
Name:KHATRI, PYAR
Entity Type:Individual
Prefix:
First Name:PYAR
Middle Name:
Last Name:KHATRI
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:PO BOX 28
Mailing Address - Street 2:
Mailing Address - City:REDWOOD CITY
Mailing Address - State:CA
Mailing Address - Zip Code:94064-0028
Mailing Address - Country:US
Mailing Address - Phone:650-530-0490
Mailing Address - Fax:
Practice Address - Street 1:610 ELM ST
Practice Address - Street 2:SUITE 210
Practice Address - City:SAN CARLOS
Practice Address - State:CA
Practice Address - Zip Code:94070-8401
Practice Address - Country:US
Practice Address - Phone:650-591-9623
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2014-05-29
Last Update Date:2023-06-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
106H00000X
CA5286101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
No106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist