Provider Demographics
NPI:1386059483
Name:GOKHALE, RIVA
Entity type:Individual
Prefix:
First Name:RIVA
Middle Name:
Last Name:GOKHALE
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 1:2340 IRVING ST
Mailing Address - Street 2:SUITE 108
Mailing Address - City:SAN FRANCISCO
Mailing Address - State:CA
Mailing Address - Zip Code:94122-1641
Mailing Address - Country:US
Mailing Address - Phone:415-860-7765
Mailing Address - Fax:
Practice Address - Street 1:2340 IRVING ST
Practice Address - Street 2:SUITE 108
Practice Address - City:SAN FRANCISCO
Practice Address - State:CA
Practice Address - Zip Code:94122-1641
Practice Address - Country:US
Practice Address - Phone:415-860-7765
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2014-06-26
Last Update Date:2014-06-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA16631235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist