Provider Demographics
NPI:1336754894
Name:PATEL, SHIVANI (PHD)
Entity Type:Individual
Prefix:DR
First Name:SHIVANI
Middle Name:
Last Name:PATEL
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:321 MIDDLEFIELD RD STE 130
Mailing Address - Street 2:
Mailing Address - City:MENLO PARK
Mailing Address - State:CA
Mailing Address - Zip Code:94025-4010
Mailing Address - Country:US
Mailing Address - Phone:650-736-2000
Mailing Address - Fax:650-736-3406
Practice Address - Street 1:321 MIDDLEFIELD RD STE 130
Practice Address - Street 2:
Practice Address - City:MENLO PARK
Practice Address - State:CA
Practice Address - Zip Code:94025-4010
Practice Address - Country:US
Practice Address - Phone:650-736-2000
Practice Address - Fax:650-736-3406
Is Sole Proprietor?:No
Enumeration Date:2020-09-11
Last Update Date:2020-09-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist