Provider Demographics
NPI:1871715821
Name:BHAGAUTI, MEERA (MA)
Entity type:Individual
Prefix:
First Name:MEERA
Middle Name:
Last Name:BHAGAUTI
Suffix:
Gender:F
Credentials:MA
Other - Prefix:
Other - First Name:MEERA
Other - Middle Name:BHAGAUTI
Other - Last Name:PITTS
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:MA
Mailing Address - Street 1:3839 GOLDWYN TER
Mailing Address - Street 2:
Mailing Address - City:CULVER CITY
Mailing Address - State:CA
Mailing Address - Zip Code:90232-3103
Mailing Address - Country:US
Mailing Address - Phone:626-442-4177
Mailing Address - Fax:626-442-4498
Practice Address - Street 1:11041 VALLEY BLVD
Practice Address - Street 2:
Practice Address - City:EL MONTE
Practice Address - State:CA
Practice Address - Zip Code:91731-2516
Practice Address - Country:US
Practice Address - Phone:626-442-4177
Practice Address - Fax:626-442-4498
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-02
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)