Provider Demographics
NPI:1235802737
Name:SAYAM, HIMA TEJASWI (PT)
Entity Type:Individual
Prefix:
First Name:HIMA TEJASWI
Middle Name:
Last Name:SAYAM
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 1:1990 SAN JUAN RD APT 137
Mailing Address - Street 2:
Mailing Address - City:SACRAMENTO
Mailing Address - State:CA
Mailing Address - Zip Code:95833-3330
Mailing Address - Country:US
Mailing Address - Phone:318-680-7296
Mailing Address - Fax:
Practice Address - Street 1:1990 SAN JUAN RD APT 137
Practice Address - Street 2:
Practice Address - City:SACRAMENTO
Practice Address - State:CA
Practice Address - Zip Code:95833-3330
Practice Address - Country:US
Practice Address - Phone:318-680-7296
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-07-29
Last Update Date:2021-07-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAPT300353225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGroup - Single Specialty