Basic Information
| Provider Information | |||||||||
| NPI: | 1063844975 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | VASWANI | ||||||||
| FirstName: | VISHAL | ||||||||
| MiddleName: | VIJAY | ||||||||
| NamePrefix: | MR. | ||||||||
| NameSuffix: | |||||||||
| Credential: | LMHC | ||||||||
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| Mailing Information | |||||||||
| Address1: | 2855 TELEGRAPH AVE STE 515 | ||||||||
| Address2: | |||||||||
| City: | BERKELEY | ||||||||
| State: | CA | ||||||||
| PostalCode: | 947051151 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5103454379 | ||||||||
| FaxNumber: | |||||||||
| Practice Location | |||||||||
| Address1: | 2855 TELEGRAPH AVE STE 515 | ||||||||
| Address2: | |||||||||
| City: | BERKELEY | ||||||||
| State: | CA | ||||||||
| PostalCode: | 947051151 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5103454379 | ||||||||
| FaxNumber: | |||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 08/01/2013 | ||||||||
| LastUpdateDate: | 12/02/2021 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
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| NPICertificationDate: | 12/01/2021 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 101YM0800X | 009694 | NY | Y | Behavioral Health & Social Service Providers | Counselor | Mental Health |
No ID Information.