Provider Demographics
NPI:1417180936
Name:SABOO, JYOTI (MS, PT)
Entity Type:Individual
Prefix:MS
First Name:JYOTI
Middle Name:
Last Name:SABOO
Suffix:
Gender:F
Credentials:MS, PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1101 S WINCHESTER BLVD
Mailing Address - Street 2:STE L237
Mailing Address - City:SAN JOSE
Mailing Address - State:CA
Mailing Address - Zip Code:95128-3904
Mailing Address - Country:US
Mailing Address - Phone:408-399-7054
Mailing Address - Fax:408-354-8186
Practice Address - Street 1:17316 ZENA AVE
Practice Address - Street 2:
Practice Address - City:MONTE SERENO
Practice Address - State:CA
Practice Address - Zip Code:95030-2255
Practice Address - Country:US
Practice Address - Phone:408-399-7054
Practice Address - Fax:408-354-8186
Is Sole Proprietor?:No
Enumeration Date:2009-09-01
Last Update Date:2018-01-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAPT16358225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist