Provider Demographics
NPI:1578333795
Name:FOUNDATION PHYSICAL THERAPY
Entity Type:Organization
Organization Name:FOUNDATION PHYSICAL THERAPY
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:AKANKSHA
Authorized Official - Middle Name:ASHOKKUMAR
Authorized Official - Last Name:SOJITRA
Authorized Official - Suffix:
Authorized Official - Credentials:PT, MS,OCS,FAAOMPT
Authorized Official - Phone:408-409-6342
Mailing Address - Street 1:36131 ROSEWOOD DR
Mailing Address - Street 2:
Mailing Address - City:NEWARK
Mailing Address - State:CA
Mailing Address - Zip Code:94560-1838
Mailing Address - Country:US
Mailing Address - Phone:408-409-6342
Mailing Address - Fax:408-520-2433
Practice Address - Street 1:499 SEAPORT CT STE 101
Practice Address - Street 2:
Practice Address - City:REDWOOD CITY
Practice Address - State:CA
Practice Address - Zip Code:94063-2782
Practice Address - Country:US
Practice Address - Phone:408-409-6342
Practice Address - Fax:408-520-2433
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-01-08
Last Update Date:2024-01-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGroup - Single Specialty