Provider Demographics
NPI:1477275907
Name:LAKHIA, POOJA THAKER (RPT)
Entity Type:Individual
Prefix:
First Name:POOJA
Middle Name:THAKER
Last Name:LAKHIA
Suffix:
Gender:F
Credentials:RPT
Other - Prefix:
Other - First Name:POOJA
Other - Middle Name:ANIRUDH
Other - Last Name:THAKER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:556 S CASITA ST
Mailing Address - Street 2:
Mailing Address - City:ANAHEIM
Mailing Address - State:CA
Mailing Address - Zip Code:92805-4748
Mailing Address - Country:US
Mailing Address - Phone:714-507-8503
Mailing Address - Fax:
Practice Address - Street 1:556 S CASITA ST
Practice Address - Street 2:
Practice Address - City:ANAHEIM
Practice Address - State:CA
Practice Address - Zip Code:92805-4748
Practice Address - Country:US
Practice Address - Phone:714-507-8503
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-09-12
Last Update Date:2022-09-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA301974225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGroup - Single Specialty