Provider Demographics
NPI:1194982611
Name:PRASAD, NITA (LMFT)
Entity type:Individual
Prefix:
First Name:NITA
Middle Name:
Last Name:PRASAD
Suffix:
Gender:F
Credentials:LMFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:39833 PASEO PADRE PKWY STE F
Mailing Address - Street 2:
Mailing Address - City:FREMONT
Mailing Address - State:CA
Mailing Address - Zip Code:94538-2980
Mailing Address - Country:US
Mailing Address - Phone:650-564-7370
Mailing Address - Fax:
Practice Address - Street 1:39833 PASEO PADRE PKWY STE F
Practice Address - Street 2:
Practice Address - City:FREMONT
Practice Address - State:CA
Practice Address - Zip Code:94538-2980
Practice Address - Country:US
Practice Address - Phone:650-564-7370
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-05-21
Last Update Date:2021-04-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAMFC43500101YA0400X
CA43500101YM0800X
CAMFC 43500101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)