Provider Demographics
NPI:1558832600
Name:DESHPANDE, YAMINI
Entity Type:Individual
Prefix:
First Name:YAMINI
Middle Name:
Last Name:DESHPANDE
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 1:901 LEVERING AVE APT 37
Mailing Address - Street 2:
Mailing Address - City:LOS ANGELES
Mailing Address - State:CA
Mailing Address - Zip Code:90024-2783
Mailing Address - Country:US
Mailing Address - Phone:317-603-6462
Mailing Address - Fax:
Practice Address - Street 1:13000 VICTORY BLVD
Practice Address - Street 2:
Practice Address - City:NORTH HOLLYWOOD
Practice Address - State:CA
Practice Address - Zip Code:91606-2926
Practice Address - Country:US
Practice Address - Phone:818-985-5990
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-12-16
Last Update Date:2018-12-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist