Provider Demographics
NPI:1285463547
Name:MAHESH, CHITRA (AMFT)
Entity type:Individual
Prefix:MS
First Name:CHITRA
Middle Name:
Last Name:MAHESH
Suffix:
Gender:F
Credentials:AMFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7624 GLENMONT DR APT A
Mailing Address - Street 2:
Mailing Address - City:NORTH ROYALTON
Mailing Address - State:OH
Mailing Address - Zip Code:44133-6828
Mailing Address - Country:US
Mailing Address - Phone:415-527-8884
Mailing Address - Fax:
Practice Address - Street 1:2547 W SHAW AVE STE 117
Practice Address - Street 2:
Practice Address - City:FRESNO
Practice Address - State:CA
Practice Address - Zip Code:93711-3321
Practice Address - Country:US
Practice Address - Phone:559-412-7799
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-07-26
Last Update Date:2024-07-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA147546106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist