Provider Demographics
NPI:1619666708
Name:AHMED CHOUDHURY, ROBIN SREJON
Entity type:Individual
Prefix:
First Name:ROBIN
Middle Name:SREJON
Last Name:AHMED CHOUDHURY
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:ROBIN
Other - Middle Name:SREJON
Other - Last Name:CHOUDHURY
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:ACSW
Mailing Address - Street 1:1922 THE ALAMEDA STE 3161922
Mailing Address - Street 2:
Mailing Address - City:SAN JOSE
Mailing Address - State:CA
Mailing Address - Zip Code:95126-1457
Mailing Address - Country:US
Mailing Address - Phone:408-261-7777
Mailing Address - Fax:408-642-6052
Practice Address - Street 1:2001 THE ALAMEDA
Practice Address - Street 2:
Practice Address - City:SAN JOSE
Practice Address - State:CA
Practice Address - Zip Code:95126-1136
Practice Address - Country:US
Practice Address - Phone:408-207-0565
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-05-04
Last Update Date:2025-08-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA124159104100000X
CAASW1241591041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker