Individual
ANVEE MANIPRASAD SHRIVASTAVA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
3132 JEFFERSON ST, SAN DIEGO, CA 92110-4421
(619) 683-3100
Mailing address
3132 JEFFERSON ST, SAN DIEGO, CA 92110-4421
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
Primary
—
—
106S00000X
Behavior Technician
—
—
Other
Enumeration date
02/14/2019
Last updated
09/12/2019
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