Provider Demographics
NPI:1376363861
Name:DEVAIAH, NEETH
Entity type:Individual
Prefix:MS
First Name:NEETH
Middle Name:
Last Name:DEVAIAH
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 1:646 ARBUTUS AVE APT 3
Mailing Address - Street 2:
Mailing Address - City:SUNNYVALE
Mailing Address - State:CA
Mailing Address - Zip Code:94086-6409
Mailing Address - Country:US
Mailing Address - Phone:650-542-0441
Mailing Address - Fax:
Practice Address - Street 1:646 ARBUTUS AVE APT 3
Practice Address - Street 2:
Practice Address - City:SUNNYVALE
Practice Address - State:CA
Practice Address - Zip Code:94086-6409
Practice Address - Country:US
Practice Address - Phone:650-542-0441
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-10-10
Last Update Date:2024-10-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA11905225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist