Provider Information for 1295568657
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NATARAJAN GOWDA Ph.D., LCSW
Sex: Male
NPI: 1295568657
Last Updated: 2024-08-21
Certification Date: 2024-08-21
Certification Date: 2024-08-21
Details
Name | Value | ||||||||
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NPI | 1295568657 | ||||||||
Enumeration Date | 2024-08-21 | ||||||||
NPI Type | NPI-1 Individual | ||||||||
Sole Proprietor | YES | ||||||||
Status | Active | ||||||||
Mailing Address | 4212 WESTMINSTER CIR FREMONT, CA 94536-5880 United States Phone: 510-381-4791 | Fax: | ||||||||
Primary Practice Address | 39275 STATE ST FREMONT, CA 94538-1437 United States Phone: 510-381-4791 | Fax: | ||||||||
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