Provider Demographics
NPI:1912137423
Name:GILTAJI, VANUI (PSYD)
Entity Type:Individual
Prefix:DR
First Name:VANUI
Middle Name:
Last Name:GILTAJI
Suffix:
Gender:F
Credentials:PSYD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:41 E FOOTHILL BLVD
Mailing Address - Street 2:STE 102
Mailing Address - City:ARCADIA
Mailing Address - State:CA
Mailing Address - Zip Code:91006-2361
Mailing Address - Country:US
Mailing Address - Phone:626-701-4249
Mailing Address - Fax:626-737-6034
Practice Address - Street 1:41 E FOOTHILL BLVD
Practice Address - Street 2:STE 102
Practice Address - City:ARCADIA
Practice Address - State:CA
Practice Address - Zip Code:91006-2361
Practice Address - Country:US
Practice Address - Phone:626-701-4249
Practice Address - Fax:626-737-6034
Is Sole Proprietor?:No
Enumeration Date:2009-07-17
Last Update Date:2019-04-04
Deactivation Date:2013-04-19
Deactivation Code:
Reactivation Date:2015-02-10
Provider Licenses
StateLicense IDTaxonomies
CAPSY26826103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical