Basic Information
Provider Information
NPI: 1487830873
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: SINGH
FirstName: NIRA
MiddleName:  
NamePrefix:  
NameSuffix:  
Credential: PSY.D.
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 2400 MOORPARK AVE 300
Address2:  
City: SAN JOSE
State: CA
PostalCode: 951282680
CountryCode: US
TelephoneNumber: 4089752730
FaxNumber: 4089752745
Practice Location
Address1: 2400 MOORPARK AVE 300
Address2:  
City: SAN JOSE
State: CA
PostalCode: 951282680
CountryCode: US
TelephoneNumber: 4089752730
FaxNumber: 4089752745
Other Information
ProviderEnumerationDate: 01/15/2008
LastUpdateDate: 10/18/2018
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: F
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
103TC0700X19201CAY Behavioral Health & Social Service ProvidersPsychologistClinical

No ID Information.


Home