Provider Demographics
NPI:1669061370
Name:MALHOTRA, DIMPLE KAUR (PHD)
Entity type:Individual
Prefix:
First Name:DIMPLE
Middle Name:KAUR
Last Name:MALHOTRA
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 1:3395 MICHELSON DR APT 4141
Mailing Address - Street 2:
Mailing Address - City:IRVINE
Mailing Address - State:CA
Mailing Address - Zip Code:92612-3403
Mailing Address - Country:US
Mailing Address - Phone:408-609-4983
Mailing Address - Fax:
Practice Address - Street 1:3395 MICHELSON DR APT 4141
Practice Address - Street 2:
Practice Address - City:IRVINE
Practice Address - State:CA
Practice Address - Zip Code:92612-3403
Practice Address - Country:US
Practice Address - Phone:408-609-4983
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-01-16
Last Update Date:2021-01-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225600000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersDance Therapist
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
No103T00000XBehavioral Health & Social Service ProvidersPsychologist
No103TC1900XBehavioral Health & Social Service ProvidersPsychologistCounselingGroup - Single Specialty
No221700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersArt Therapist