Provider Demographics
NPI:1609624352
Name:KATRAGADDA, SRINIVAS (LMFT)
Entity type:Individual
Prefix:
First Name:SRINIVAS
Middle Name:
Last Name:KATRAGADDA
Suffix:
Gender:M
Credentials:LMFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5640 FERNHOFF RD
Mailing Address - Street 2:
Mailing Address - City:OAKLAND
Mailing Address - State:CA
Mailing Address - Zip Code:94619-3113
Mailing Address - Country:US
Mailing Address - Phone:408-891-0879
Mailing Address - Fax:
Practice Address - Street 1:5640 FERNHOFF RD
Practice Address - Street 2:
Practice Address - City:OAKLAND
Practice Address - State:CA
Practice Address - Zip Code:94619-3113
Practice Address - Country:US
Practice Address - Phone:415-625-3006
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-05-08
Last Update Date:2024-05-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health