Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 103TC1900X | Counseling Psychologist | PSY 21861 | CA |
NPI | 1114283868 |
---|---|
Provider Name | Dr. Neesha Patel |
First Address | Berkeley, CA 94705-2225 |
Second Address | Berkeley, CA 94704-2365 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 06/04/2012 |
Last Update Date | 13/09/2013 |