Provider Demographics
NPI:1922386234
Name:NARASIMHA, VASUDHA DEVANATHAN (ACSW)
Entity Type:Individual
Prefix:
First Name:VASUDHA
Middle Name:DEVANATHAN
Last Name:NARASIMHA
Suffix:
Gender:F
Credentials:ACSW
Other - Prefix:
Other - First Name:VASUDHA
Other - Middle Name:
Other - Last Name:DEVANATHAN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MSW
Mailing Address - Street 1:250 EXECUTIVE PARK BLVD
Mailing Address - Street 2:SUITE 4900
Mailing Address - City:SAN FRANCISCO
Mailing Address - State:CA
Mailing Address - Zip Code:94134-3394
Mailing Address - Country:US
Mailing Address - Phone:415-656-0116
Mailing Address - Fax:415-656-0117
Practice Address - Street 1:250 EXECUTIVE PARK BLVD
Practice Address - Street 2:SUITE 4900
Practice Address - City:SAN FRANCISCO
Practice Address - State:CA
Practice Address - Zip Code:94134-3394
Practice Address - Country:US
Practice Address - Phone:415-656-0116
Practice Address - Fax:415-656-0117
Is Sole Proprietor?:No
Enumeration Date:2011-08-03
Last Update Date:2015-12-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA390200000X
CA33346101YM0800X, 104100000X
CALCSW 699381041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
No104100000XBehavioral Health & Social Service ProvidersSocial Worker