Provider Demographics
NPI:1033485776
Name:SHARMA, ANJU (PT)
Entity Type:Individual
Prefix:
First Name:ANJU
Middle Name:
Last Name:SHARMA
Suffix:
Gender:F
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2942 CHESWYCKE TER
Mailing Address - Street 2:APT 157
Mailing Address - City:FREMONT
Mailing Address - State:CA
Mailing Address - Zip Code:94536-1903
Mailing Address - Country:US
Mailing Address - Phone:602-773-1058
Mailing Address - Fax:
Practice Address - Street 1:2942 CHESWYCKE TER
Practice Address - Street 2:APT 157
Practice Address - City:FREMONT
Practice Address - State:CA
Practice Address - Zip Code:94536-1903
Practice Address - Country:US
Practice Address - Phone:602-773-1058
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-03-27
Last Update Date:2022-02-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA38039225100000X
MI5501014771225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist