Provider Demographics
NPI:1861900367
Name:GOLDEN GATE PSYCHIATRY ASSOCIATES
Entity type:Organization
Organization Name:GOLDEN GATE PSYCHIATRY ASSOCIATES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MD
Authorized Official - Prefix:
Authorized Official - First Name:NAGARAJ
Authorized Official - Middle Name:
Authorized Official - Last Name:UDDHANDI
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:408-474-0904
Mailing Address - Street 1:604 N 9TH ST
Mailing Address - Street 2:
Mailing Address - City:SAN JOSE
Mailing Address - State:CA
Mailing Address - Zip Code:95112-3250
Mailing Address - Country:US
Mailing Address - Phone:408-474-0904
Mailing Address - Fax:408-474-0929
Practice Address - Street 1:2570 N 1ST ST STE 216
Practice Address - Street 2:
Practice Address - City:SAN JOSE
Practice Address - State:CA
Practice Address - Zip Code:95131-1035
Practice Address - Country:US
Practice Address - Phone:408-474-0904
Practice Address - Fax:408-474-0929
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-01-18
Last Update Date:2019-01-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatryGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA1942456108OtherPSYCHIATRY
CAY4740890OtherDRIVERS LICENSE