Provider Demographics
NPI:1912498866
Name:DINDYAL, MANJU DEVI
Entity Type:Individual
Prefix:MRS
First Name:MANJU
Middle Name:DEVI
Last Name:DINDYAL
Suffix:
Gender:F
Credentials:
Other - Prefix:MISS
Other - First Name:MANJU
Other - Middle Name:
Other - Last Name:DEVI
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:7674 DARLA WAY
Mailing Address - Street 2:
Mailing Address - City:SACRAMENTO
Mailing Address - State:CA
Mailing Address - Zip Code:95828-5611
Mailing Address - Country:US
Mailing Address - Phone:916-708-5253
Mailing Address - Fax:
Practice Address - Street 1:7674 DARLA WAY
Practice Address - Street 2:
Practice Address - City:SACRAMENTO
Practice Address - State:CA
Practice Address - Zip Code:95828-5611
Practice Address - Country:US
Practice Address - Phone:916-708-5253
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-05-27
Last Update Date:2018-05-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA106S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician