Provider Demographics
NPI:1447141312
Name:DAS, KANAK PRAVA (ACSW)
Entity type:Individual
Prefix:
First Name:KANAK
Middle Name:PRAVA
Last Name:DAS
Suffix:
Gender:X
Credentials:ACSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1949 LOCKWOOD LN
Mailing Address - Street 2:
Mailing Address - City:CORONA
Mailing Address - State:CA
Mailing Address - Zip Code:92881-7450
Mailing Address - Country:US
Mailing Address - Phone:951-591-3708
Mailing Address - Fax:
Practice Address - Street 1:440 E HUNTINGTON DR STE 311
Practice Address - Street 2:
Practice Address - City:ARCADIA
Practice Address - State:CA
Practice Address - Zip Code:91006-3776
Practice Address - Country:US
Practice Address - Phone:323-206-6370
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-07-10
Last Update Date:2025-07-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical