Provider Demographics
NPI:1669297792
Name:PRABHU CHANDHAR, VARUNESH
Entity type:Individual
Prefix:
First Name:VARUNESH
Middle Name:
Last Name:PRABHU CHANDHAR
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4142 WAKEFIELD LOOP
Mailing Address - Street 2:
Mailing Address - City:FREMONT
Mailing Address - State:CA
Mailing Address - Zip Code:94536-4741
Mailing Address - Country:US
Mailing Address - Phone:510-953-9938
Mailing Address - Fax:
Practice Address - Street 1:4142 WAKEFIELD LOOP
Practice Address - Street 2:
Practice Address - City:FREMONT
Practice Address - State:CA
Practice Address - Zip Code:94536-4741
Practice Address - Country:US
Practice Address - Phone:510-953-9938
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-11-22
Last Update Date:2024-11-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician