Provider Demographics
NPI:1629342340
Name:GOTTAPU, APARAJITHA (PT)
Entity Type:Individual
Prefix:
First Name:APARAJITHA
Middle Name:
Last Name:GOTTAPU
Suffix:
Gender:F
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2488 DE LA CRUZ BLVD
Mailing Address - Street 2:
Mailing Address - City:SANTA CLARA
Mailing Address - State:CA
Mailing Address - Zip Code:95050-2923
Mailing Address - Country:US
Mailing Address - Phone:408-247-7278
Mailing Address - Fax:408-247-9320
Practice Address - Street 1:2488 DE LA CRUZ BLVD
Practice Address - Street 2:
Practice Address - City:SANTA CLARA
Practice Address - State:CA
Practice Address - Zip Code:95050-2923
Practice Address - Country:US
Practice Address - Phone:408-247-7278
Practice Address - Fax:408-247-9320
Is Sole Proprietor?:No
Enumeration Date:2012-02-27
Last Update Date:2017-01-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAPT 38540225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAGD482ZMedicare PIN