Provider Demographics
NPI:1821466756
Name:PATEL, SHAILJA J (PT)
Entity Type:Individual
Prefix:
First Name:SHAILJA
Middle Name:J
Last Name:PATEL
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Gender:F
Credentials:PT
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Mailing Address - Street 1:1895 MOWRY AVE
Mailing Address - Street 2:STE 118A
Mailing Address - City:FREMONT
Mailing Address - State:CA
Mailing Address - Zip Code:94538-1737
Mailing Address - Country:US
Mailing Address - Phone:951-696-9353
Mailing Address - Fax:951-973-7216
Practice Address - Street 1:12402 INDUSTRIAL BLVD
Practice Address - Street 2:SUITE B2
Practice Address - City:VICTORVILLE
Practice Address - State:CA
Practice Address - Zip Code:92395-5871
Practice Address - Country:US
Practice Address - Phone:760-955-6061
Practice Address - Fax:760-955-6062
Is Sole Proprietor?:No
Enumeration Date:2015-09-09
Last Update Date:2021-12-28
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Provider Licenses
StateLicense IDTaxonomies
CA43027225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist