Provider Demographics
NPI:1134964760
Name:MOHANAN, SHARMILA (PT)
Entity type:Individual
Prefix:
First Name:SHARMILA
Middle Name:
Last Name:MOHANAN
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 1:555 MOWRY AVE STE E
Mailing Address - Street 2:
Mailing Address - City:FREMONT
Mailing Address - State:CA
Mailing Address - Zip Code:94536-4101
Mailing Address - Country:US
Mailing Address - Phone:510-745-7000
Mailing Address - Fax:
Practice Address - Street 1:555 MOWRY AVE STE E
Practice Address - Street 2:
Practice Address - City:FREMONT
Practice Address - State:CA
Practice Address - Zip Code:94536-4101
Practice Address - Country:US
Practice Address - Phone:510-745-7000
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-06-26
Last Update Date:2024-06-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist