Provider Demographics
NPI:1194692681
Name:BATH, MANJIT (PSYD)
Entity type:Individual
Prefix:DR
First Name:MANJIT
Middle Name:
Last Name:BATH
Suffix:
Gender:M
Credentials:PSYD
Other - Prefix:DR
Other - First Name:MANJ
Other - Middle Name:
Other - Last Name:BATH
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:PSYD
Mailing Address - Street 1:12120 WOODHEAD RD.
Mailing Address - Street 2:
Mailing Address - City:RICHMOND
Mailing Address - State:BC
Mailing Address - Zip Code:V6V1G3
Mailing Address - Country:CA
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:12120 WOODHEAD RD.
Practice Address - Street 2:
Practice Address - City:RICHMOND
Practice Address - State:BC
Practice Address - Zip Code:V6V1G3
Practice Address - Country:CA
Practice Address - Phone:
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-10-20
Last Update Date:2025-10-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAPSYC.PY.70003443103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical