Provider Demographics
NPI:1336857242
Name:BULSARA, PRACHI MUKESH
Entity Type:Individual
Prefix:
First Name:PRACHI
Middle Name:MUKESH
Last Name:BULSARA
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1524 PEARL ST
Mailing Address - Street 2:
Mailing Address - City:MODESTO
Mailing Address - State:CA
Mailing Address - Zip Code:95350-3870
Mailing Address - Country:US
Mailing Address - Phone:209-604-3804
Mailing Address - Fax:
Practice Address - Street 1:620 SAND HILL RD
Practice Address - Street 2:
Practice Address - City:PALO ALTO
Practice Address - State:CA
Practice Address - Zip Code:94304-2699
Practice Address - Country:US
Practice Address - Phone:888-926-1850
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-11-09
Last Update Date:2022-11-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist