Provider Demographics
NPI:1770067340
Name:UPADHYAYA, NANDITA SHRIDHARA
Entity type:Individual
Prefix:MS
First Name:NANDITA SHRIDHARA
Middle Name:
Last Name:UPADHYAYA
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 1:2261 RITA CT
Mailing Address - Street 2:
Mailing Address - City:SANTA CLARA
Mailing Address - State:CA
Mailing Address - Zip Code:95050-5617
Mailing Address - Country:US
Mailing Address - Phone:909-736-8652
Mailing Address - Fax:
Practice Address - Street 1:2261 RITA CT
Practice Address - Street 2:
Practice Address - City:SANTA CLARA
Practice Address - State:CA
Practice Address - Zip Code:95050-5617
Practice Address - Country:US
Practice Address - Phone:909-736-8652
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-09-19
Last Update Date:2024-06-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CASP26809235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist