Provider Demographics
NPI:1265415012
Name:GANDHI, ASHA MAHENDRA (MD)
Entity type:Individual
Prefix:MRS
First Name:ASHA
Middle Name:MAHENDRA
Last Name:GANDHI
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:410 DUNBLANE DR
Mailing Address - Street 2:
Mailing Address - City:WALNUT CREEK
Mailing Address - State:CA
Mailing Address - Zip Code:94598-3331
Mailing Address - Country:US
Mailing Address - Phone:925-946-9652
Mailing Address - Fax:
Practice Address - Street 1:1600 CALIFORNIA DRIVE
Practice Address - Street 2:DEPT. OF MENTAL HEALTH, DEPT. OF CORRECTIONS
Practice Address - City:VACAVILLE
Practice Address - State:CA
Practice Address - Zip Code:95696
Practice Address - Country:US
Practice Address - Phone:707-449-6589
Practice Address - Fax:707-453-7097
Is Sole Proprietor?:No
Enumeration Date:2005-11-25
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA0346122084F0202X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084F0202XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyForensic Psychiatry
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA0A346120Medicaid
CA0A346120Medicaid