Provider Demographics
NPI:1366553240
Name:THUKRAL, NUPUR
Entity type:Individual
Prefix:
First Name:NUPUR
Middle Name:
Last Name:THUKRAL
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:995 MONTAGUE EXPY
Mailing Address - Street 2:SUITE #213
Mailing Address - City:MILPITAS
Mailing Address - State:CA
Mailing Address - Zip Code:95035-6851
Mailing Address - Country:US
Mailing Address - Phone:408-254-9900
Mailing Address - Fax:408-258-2175
Practice Address - Street 1:995 MONTAGUE EXPY
Practice Address - Street 2:SUITE #213
Practice Address - City:MILPITAS
Practice Address - State:CA
Practice Address - Zip Code:95035-6851
Practice Address - Country:US
Practice Address - Phone:408-254-9900
Practice Address - Fax:408-258-2175
Is Sole Proprietor?:No
Enumeration Date:2006-08-31
Last Update Date:2009-08-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CASP9830235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist
Provider Identifiers
StateIdentifier IDID TypeIssuer
CASP9830OtherSTATE BOARD LICENSE NUMBE