Provider Demographics
NPI:1417187832
Name:KORADIA, CHERISHA HEMANT (DPT, PT,MS,GCS)
Entity Type:Individual
Prefix:DR
First Name:CHERISHA
Middle Name:HEMANT
Last Name:KORADIA
Suffix:
Gender:F
Credentials:DPT, PT,MS,GCS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2191 BLOSSOM VALLEY DR
Mailing Address - Street 2:
Mailing Address - City:SAN JOSE
Mailing Address - State:CA
Mailing Address - Zip Code:95124-6053
Mailing Address - Country:US
Mailing Address - Phone:323-512-1060
Mailing Address - Fax:
Practice Address - Street 1:2191 BLOSSOM VALLEY DR
Practice Address - Street 2:
Practice Address - City:SAN JOSE
Practice Address - State:CA
Practice Address - Zip Code:95124-6053
Practice Address - Country:US
Practice Address - Phone:323-512-1060
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2009-07-20
Last Update Date:2022-09-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAPT 39330225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAGU873ZMedicare PIN