Provider Demographics
NPI:1992834626
Name:PRASAD, SANGITA (PSYD)
Entity Type:Individual
Prefix:DR
First Name:SANGITA
Middle Name:
Last Name:PRASAD
Suffix:
Gender:F
Credentials:PSYD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:100 PRISON RD
Mailing Address - Street 2:CA DEPT OF CORRECTIONS AND REHABILITATION
Mailing Address - City:REPRESA
Mailing Address - State:CA
Mailing Address - Zip Code:95671-0012
Mailing Address - Country:US
Mailing Address - Phone:916-985-8610
Mailing Address - Fax:916-294-3056
Practice Address - Street 1:100 PRISON ROAD
Practice Address - Street 2:CA DEPT OF CORRECTION AND REHABILITATION
Practice Address - City:REPRESA
Practice Address - State:CA
Practice Address - Zip Code:95671-0012
Practice Address - Country:US
Practice Address - Phone:916-985-8610
Practice Address - Fax:916-294-3056
Is Sole Proprietor?:No
Enumeration Date:2007-03-06
Last Update Date:2022-02-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program
No104100000XBehavioral Health & Social Service ProvidersSocial Worker
No171M00000XOther Service ProvidersCase Manager/Care Coordinator
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA1992834626OtherCDCR EMPLOYEE