Provider Demographics
NPI:1902174550
Name:KANIEL, BATYA (MA, MFT)
Entity Type:Individual
Prefix:
First Name:BATYA
Middle Name:
Last Name:KANIEL
Suffix:
Gender:F
Credentials:MA, MFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4100 MOORPARK AVE
Mailing Address - Street 2:SUITE 116
Mailing Address - City:SAN JOSE
Mailing Address - State:CA
Mailing Address - Zip Code:95117-1703
Mailing Address - Country:US
Mailing Address - Phone:408-327-9521
Mailing Address - Fax:408-249-9204
Practice Address - Street 1:4100 MOORPARK AVE
Practice Address - Street 2:SUITE 116
Practice Address - City:SAN JOSE
Practice Address - State:CA
Practice Address - Zip Code:95117-1703
Practice Address - Country:US
Practice Address - Phone:408-327-9521
Practice Address - Fax:408-249-9204
Is Sole Proprietor?:Yes
Enumeration Date:2011-12-11
Last Update Date:2011-12-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAMFT22673106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist