Provider Demographics
NPI:1891461794
Name:KUTTUVA, AKSHETA SURESH (MA CLINICAL PSYCH)
Entity Type:Individual
Prefix:MS
First Name:AKSHETA
Middle Name:SURESH
Last Name:KUTTUVA
Suffix:
Gender:F
Credentials:MA CLINICAL PSYCH
Other - Prefix:
Other - First Name:
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Other - Credentials:
Mailing Address - Street 1:3075 ADELINE ST STE 120
Mailing Address - Street 2:
Mailing Address - City:BERKELEY
Mailing Address - State:CA
Mailing Address - Zip Code:94703-2579
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:39420 LIBERTY ST STE 252
Practice Address - Street 2:
Practice Address - City:FREMONT
Practice Address - State:CA
Practice Address - Zip Code:94538-2297
Practice Address - Country:US
Practice Address - Phone:510-745-9151
Practice Address - Fax:510-745-9152
Is Sole Proprietor?:No
Enumeration Date:2021-08-19
Last Update Date:2023-07-11
Deactivation Date:
Deactivation Code:
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Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC1900XBehavioral Health & Social Service ProvidersPsychologistCounseling
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program