Provider Demographics
NPI:1548144066
Name:UMASHANKAR, ATHIRA NISHA
Entity type:Individual
Prefix:
First Name:ATHIRA
Middle Name:NISHA
Last Name:UMASHANKAR
Suffix:
Gender:X
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10860 BREAKING ROCKS DR
Mailing Address - Street 2:
Mailing Address - City:TAMPA
Mailing Address - State:FL
Mailing Address - Zip Code:33647-3579
Mailing Address - Country:US
Mailing Address - Phone:813-997-8187
Mailing Address - Fax:
Practice Address - Street 1:5028 SILVER CHARM TER
Practice Address - Street 2:
Practice Address - City:WESLEY CHAPEL
Practice Address - State:FL
Practice Address - Zip Code:33544-1582
Practice Address - Country:US
Practice Address - Phone:908-938-1577
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-08-05
Last Update Date:2025-08-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician