Provider Demographics
NPI:1447596556
Name:PASHA, AFROZ SADAT (PT)
Entity Type:Individual
Prefix:
First Name:AFROZ
Middle Name:SADAT
Last Name:PASHA
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 1:5065 HAVEN PL
Mailing Address - Street 2:APT #203
Mailing Address - City:DUBLIN
Mailing Address - State:CA
Mailing Address - Zip Code:94568-7915
Mailing Address - Country:US
Mailing Address - Phone:925-216-5531
Mailing Address - Fax:
Practice Address - Street 1:14766 WASHINGTON AVE
Practice Address - Street 2:
Practice Address - City:SAN LEANDRO
Practice Address - State:CA
Practice Address - Zip Code:94578-4220
Practice Address - Country:US
Practice Address - Phone:510-352-2211
Practice Address - Fax:510-352-8731
Is Sole Proprietor?:Yes
Enumeration Date:2012-12-17
Last Update Date:2012-12-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA36471225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist