Provider Demographics
NPI:1740142637
Name:KOLLURU, HARITHA
Entity type:Individual
Prefix:MS
First Name:HARITHA
Middle Name:
Last Name:KOLLURU
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 1:8110 MOUNTAIN VIEW DR APT C
Mailing Address - Street 2:
Mailing Address - City:PLEASANTON
Mailing Address - State:CA
Mailing Address - Zip Code:94588-4749
Mailing Address - Country:US
Mailing Address - Phone:630-877-5982
Mailing Address - Fax:
Practice Address - Street 1:8110 MOUNTAIN VIEW DR APT C
Practice Address - Street 2:
Practice Address - City:PLEASANTON
Practice Address - State:CA
Practice Address - Zip Code:94588-4749
Practice Address - Country:US
Practice Address - Phone:630-877-5982
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-11-29
Last Update Date:2025-11-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician