Provider Demographics
NPI:1093458713
Name:PATEL, RAJVI (OTD, OTR/L)
Entity Type:Individual
Prefix:
First Name:RAJVI
Middle Name:
Last Name:PATEL
Suffix:
Gender:F
Credentials:OTD, OTR/L
Other - Prefix:
Other - First Name:RAJVI
Other - Middle Name:
Other - Last Name:PATEL
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:OTD, OTR/L
Mailing Address - Street 1:18424 BAINBROOK CT
Mailing Address - Street 2:
Mailing Address - City:CERRITOS
Mailing Address - State:CA
Mailing Address - Zip Code:90703-6317
Mailing Address - Country:US
Mailing Address - Phone:562-896-5351
Mailing Address - Fax:
Practice Address - Street 1:18424 BAINBROOK CT
Practice Address - Street 2:
Practice Address - City:CERRITOS
Practice Address - State:CA
Practice Address - Zip Code:90703-6317
Practice Address - Country:US
Practice Address - Phone:562-896-5351
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-04-20
Last Update Date:2022-04-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA23375225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist