Provider Demographics
NPI:1497390256
Name:MAJMUNDAR, UPASNA VEDANT (PT)
Entity Type:Individual
Prefix:
First Name:UPASNA
Middle Name:VEDANT
Last Name:MAJMUNDAR
Suffix:
Gender:F
Credentials:PT
Other - Prefix:
Other - First Name:UPASNA
Other - Middle Name:NIHAR
Other - Last Name:TRIVEDI
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:9090 MOODY ST APT 111
Mailing Address - Street 2:
Mailing Address - City:CYPRESS
Mailing Address - State:CA
Mailing Address - Zip Code:90630-2940
Mailing Address - Country:US
Mailing Address - Phone:714-833-8715
Mailing Address - Fax:
Practice Address - Street 1:988 WALSH AVE
Practice Address - Street 2:
Practice Address - City:SANTA CLARA
Practice Address - State:CA
Practice Address - Zip Code:95050-2649
Practice Address - Country:US
Practice Address - Phone:408-988-6868
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-11-14
Last Update Date:2019-11-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist