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Organization
PRODIGY PSYCHIATRIC GROUP
Active
Organization
PRODIGY PSYCHIATRIC GROUP
Active
Organization subpart
No
Provider details
NPI number
Authorized official
BEETA R VERMA MD (PRESIDENT)
(510) 875-7721
Entity
Organization
Contact information
Practice address
5791 CAPILANO DR, SAN JOSE, CA 95138-2364
(408) 630-1209
Mailing address
5791 CAPILANO DR, SAN JOSE, CA 95138-2364
(510) 875-7721
Taxonomy
Speciality
Code
Description
License number
State
2084P0800X
Psychiatry Physician
Primary
—
—
2084P0804X
Child & Adolescent Psychiatry Physician
—
—
Other
Enumeration date
06/08/2019
Last updated
10/26/2022
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