Provider Demographics
NPI:1982246732
Name:BADONI, PARVATI
Entity type:Individual
Prefix:
First Name:PARVATI
Middle Name:
Last Name:BADONI
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 1:6699 BOGIALA WAY
Mailing Address - Street 2:
Mailing Address - City:GILROY
Mailing Address - State:CA
Mailing Address - Zip Code:95020-7108
Mailing Address - Country:US
Mailing Address - Phone:408-416-7539
Mailing Address - Fax:408-413-4448
Practice Address - Street 1:3031 TISCH WAY
Practice Address - Street 2:
Practice Address - City:SAN JOSE
Practice Address - State:CA
Practice Address - Zip Code:95128-2541
Practice Address - Country:US
Practice Address - Phone:408-413-4448
Practice Address - Fax:408-413-4448
Is Sole Proprietor?:No
Enumeration Date:2019-10-14
Last Update Date:2023-09-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA1-19-37434103K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst