Provider Demographics
NPI:1124833389
Name:PRASAD, SANDHYA SHALINI
Entity type:Individual
Prefix:
First Name:SANDHYA
Middle Name:SHALINI
Last Name:PRASAD
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:26337 HUNTWOOD AVE
Mailing Address - Street 2:
Mailing Address - City:HAYWARD
Mailing Address - State:CA
Mailing Address - Zip Code:94544-3302
Mailing Address - Country:US
Mailing Address - Phone:510-552-9314
Mailing Address - Fax:
Practice Address - Street 1:494 BLOSSOM WAY
Practice Address - Street 2:
Practice Address - City:CHERRYLAND
Practice Address - State:CA
Practice Address - Zip Code:94541-1948
Practice Address - Country:US
Practice Address - Phone:510-582-7676
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-02-12
Last Update Date:2025-02-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA95348449163WP0809X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WP0809XNursing Service ProvidersRegistered NursePsychiatric/Mental Health, Adult