Individual
DR. VASUNDHARA-DEVI VEMULA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
810 5TH AVE STE 100, SAN RAFAEL, CA 94901-3252
(415) 994-9906
(415) 295-7080
Mailing address
365 BUTTERFIELD RD, SAN ANSELMO, CA 94960-1222
(415) 994-9906
(415) 295-7080
Taxonomy
Speciality
Code
Description
License number
State
2084P0800X
Psychiatry Physician
C145223
CA
2084P0804X
Child & Adolescent Psychiatry Physician
Primary
C145223
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
177740
NEW YORK LICENSE #
NY
01
—
37984
KENTUCKY LICENSE #
KY
05
—
64067812
—
KY
01
—
C145223
CALIFORNIA MEDICAL LICENSE
CA
Enumeration date
09/20/2005
Last updated
09/28/2023
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