Provider Demographics
NPI:1215503172
Name:LAKSHUMANAN, CHITRA (MA, CCC-SLP)
Entity type:Individual
Prefix:
First Name:CHITRA
Middle Name:
Last Name:LAKSHUMANAN
Suffix:
Gender:F
Credentials:MA, CCC-SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3581 DALTON CMN
Mailing Address - Street 2:
Mailing Address - City:FREMONT
Mailing Address - State:CA
Mailing Address - Zip Code:94536-6006
Mailing Address - Country:US
Mailing Address - Phone:248-238-6519
Mailing Address - Fax:
Practice Address - Street 1:4637 CHABOT DR STE 106
Practice Address - Street 2:
Practice Address - City:PLEASANTON
Practice Address - State:CA
Practice Address - Zip Code:94588-2753
Practice Address - Country:US
Practice Address - Phone:925-954-4546
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-06-01
Last Update Date:2024-12-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language PathologistGroup - Single Specialty