Provider Demographics
NPI:1396955274
Name:SUNASRA, ASHRAFI G (MASLP)
Entity type:Individual
Prefix:MS
First Name:ASHRAFI
Middle Name:G
Last Name:SUNASRA
Suffix:
Gender:F
Credentials:MASLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1395 SARATOGA AVE
Mailing Address - Street 2:APT. 46
Mailing Address - City:SAN JOSE
Mailing Address - State:CA
Mailing Address - Zip Code:95129-4453
Mailing Address - Country:US
Mailing Address - Phone:646-234-2765
Mailing Address - Fax:
Practice Address - Street 1:830 STEWART DR
Practice Address - Street 2:SUITE 139
Practice Address - City:SUNNYVALE
Practice Address - State:CA
Practice Address - Zip Code:94085-4513
Practice Address - Country:US
Practice Address - Phone:646-234-2765
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-05-22
Last Update Date:2014-05-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CASP 16422235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist