Provider Demographics
NPI:1023589207
Name:PANDHRE, ASHLESHA RAJIV
Entity type:Individual
Prefix:
First Name:ASHLESHA
Middle Name:RAJIV
Last Name:PANDHRE
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 1:950 BERRUM LN APT NO6
Mailing Address - Street 2:
Mailing Address - City:RENO
Mailing Address - State:NV
Mailing Address - Zip Code:89509-4599
Mailing Address - Country:US
Mailing Address - Phone:650-526-8480
Mailing Address - Fax:
Practice Address - Street 1:20 WEST ST
Practice Address - Street 2:
Practice Address - City:FERNLEY
Practice Address - State:NV
Practice Address - Zip Code:89408-9799
Practice Address - Country:US
Practice Address - Phone:775-575-5508
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 Licenses
StateLicense IDTaxonomies
NV3918225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist