Provider Demographics
NPI:1467913491
Name:JOSHI, POOJA AJAYKUMAR
Entity Type:Individual
Prefix:
First Name:POOJA
Middle Name:AJAYKUMAR
Last Name:JOSHI
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5583 HEMLOCK TER
Mailing Address - Street 2:
Mailing Address - City:FREMONT
Mailing Address - State:CA
Mailing Address - Zip Code:94538-2443
Mailing Address - Country:US
Mailing Address - Phone:408-221-6873
Mailing Address - Fax:
Practice Address - Street 1:1208 E ARQUES AVE STE 115
Practice Address - Street 2:
Practice Address - City:SUNNYVALE
Practice Address - State:CA
Practice Address - Zip Code:94085-5419
Practice Address - Country:US
Practice Address - Phone:408-720-1700
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-03-31
Last Update Date:2019-03-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA296481225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist