Provider Demographics
NPI:1043916836
Name:RAJULA, VANDANA (MPT)
Entity Type:Individual
Prefix:
First Name:VANDANA
Middle Name:
Last Name:RAJULA
Suffix:
Gender:F
Credentials:MPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:117 REFLECTION
Mailing Address - Street 2:
Mailing Address - City:IRVINE
Mailing Address - State:CA
Mailing Address - Zip Code:92620-2241
Mailing Address - Country:US
Mailing Address - Phone:914-413-4534
Mailing Address - Fax:
Practice Address - Street 1:92 ARGONAUT STE 170
Practice Address - Street 2:
Practice Address - City:ALISO VIEJO
Practice Address - State:CA
Practice Address - Zip Code:92656-4130
Practice Address - Country:US
Practice Address - Phone:949-916-1654
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-02-02
Last Update Date:2023-02-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2251P0200XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistPediatrics