Provider Demographics
NPI:1831761154
Name:CHANDRASEKARAN, ANITHA
Entity type:Individual
Prefix:MS
First Name:ANITHA
Middle Name:
Last Name:CHANDRASEKARAN
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 1:5018 CURTIS ST
Mailing Address - Street 2:
Mailing Address - City:FREMONT
Mailing Address - State:CA
Mailing Address - Zip Code:94538-2408
Mailing Address - Country:US
Mailing Address - Phone:925-999-5542
Mailing Address - Fax:
Practice Address - Street 1:5018 CURTIS ST
Practice Address - Street 2:
Practice Address - City:FREMONT
Practice Address - State:CA
Practice Address - Zip Code:94538-2408
Practice Address - Country:US
Practice Address - Phone:925-999-5542
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-07-15
Last Update Date:2021-07-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA29677235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist