MANASA MAHADEVAN - NPI 1053168294 - Counselor in Fairfield, CA

Q: What is Manasa Mahadevan's NPI number?

The NPI number for Manasa Mahadevan is 1053168294. It was assigned to this individual provider in the NPPES registry on May 6, 2024.

Q: What is Manasa Mahadevan's specialty?

The primary specialty registered for this NPI is Counselor, specializing in Mental Health, with taxonomy code 101YM0800X.

Q: When was this NPI record last updated?

The NPPES record for Manasa Mahadevan was last updated on May 6, 2024. NPI Profile syncs with the weekly NPPES data releases published by CMS.

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About Manasa Mahadevan NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

MANASA MAHADEVAN (NPI 1053168294) is an individual mental health provider in Fairfield, California, licensed in California (AMFT146206) and active in the NPI registry since May 2024.

NPPES Registry Identity

NPI1053168294

Entity TypeIndividualFemale

Primary Taxonomy101YM0800X

Provider Legal NameMANASA MAHADEVAN

Location Address4820 BUSINESS CENTER DR STE 110Fairfield, CA 94534-1907

Mailing Address85 Rio Robles E Unit 1111San Jose, CA 95134-1652

Phone(707) 703-5075

Sole ProprietorYes

Enumeration DateMay 6, 2024

NPPES CertifiedMay 5, 2024

✔ NPI 1053168294 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyCounselor · Mental HealthBehavioral Health & Social Service Providers

Taxonomy Code101YM0800X

License✔ Licensed in CA · AMFT146206

4820 BUSINESS CENTER DR STE 110, Fairfield, CA 94534

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Other Providers at the Same Location NPPES 7

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

MACAYLA JOSEPHINE PONCE

Physician Assistant