Provider Demographics
NPI:1720137391
Name:SANKARAN, VANITHA A (MD)
Entity Type:Individual
Prefix:
First Name:VANITHA
Middle Name:A
Last Name:SANKARAN
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7381 RAINBOW DR
Mailing Address - Street 2:
Mailing Address - City:CUPERTINO
Mailing Address - State:CA
Mailing Address - Zip Code:95014-5310
Mailing Address - Country:US
Mailing Address - Phone:408-705-3537
Mailing Address - Fax:
Practice Address - Street 1:20863 STEVENS CREEK BLVD
Practice Address - Street 2:580
Practice Address - City:CUPERTINO
Practice Address - State:CA
Practice Address - Zip Code:95014-2197
Practice Address - Country:US
Practice Address - Phone:408-705-3537
Practice Address - Fax:408-872-4122
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-10
Last Update Date:2013-07-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA1065382084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAFK890UMedicare PIN