Provider Demographics
NPI:1487701264
Name:GIRI, VASANTA VENKAT (MD)
Entity type:Individual
Prefix:DR
First Name:VASANTA
Middle Name:VENKAT
Last Name:GIRI
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
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Other - Credentials:
Mailing Address - Street 1:101 RUDGEAR DR
Mailing Address - Street 2:
Mailing Address - City:WALNUT CREEK
Mailing Address - State:CA
Mailing Address - Zip Code:94596-6353
Mailing Address - Country:US
Mailing Address - Phone:925-519-1972
Mailing Address - Fax:925-939-1169
Practice Address - Street 1:4368 LINCOLN AVE
Practice Address - Street 2:
Practice Address - City:OAKLAND
Practice Address - State:CA
Practice Address - Zip Code:94602-2529
Practice Address - Country:US
Practice Address - Phone:510-531-3111
Practice Address - Fax:510-531-8498
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-04
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
CAA341062084P0804X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0804XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyChild & Adolescent Psychiatry