Datta, Purna Chandra

Datta, Purna Chandra is an sole proprietor health care provider with primary practice located at 7510 Shoreline Dr Suite A-6, Stockton CA 95219-5495. He recently has only one registered license in Behavioral Health & Social Service Providers / Clinical, which is considered as his primary health care specialty. Datta, Purna Chandra can be contacted via phone (209) 406-6817.

Contact Information

Primary practice address
7510 Shoreline Dr Suite A-6 Stockton CA 95219-5495
Phone: (209) 406-6817
Fax: (209) 477-2935
Website:
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Health care specialties

SpecialtyCodeLicense #State
Behavioral Health & Social Service Providers / Clinical 103TC0700X PSY10808 California

Profile Details

NPI number 1275646036
LBN Legal business name Datta, Purna Chandra
Credentials PH.D.
Entity Individual
Sole proprietor 1 Yes
Enumeration date Aug 16th, 2006
Last updated Apr 12th, 2012 - about 14 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1275646036 NPPES
California Other PSY10808 BOARD OF PSYCHOLOGY

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