Provider Demographics
NPI:1376857128
Name:DHERE, RIJUTA A (PT)
Entity type:Individual
Prefix:MS
First Name:RIJUTA
Middle Name:A
Last Name:DHERE
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 1:302 COUNTRYBROOK LOOP
Mailing Address - Street 2:
Mailing Address - City:SAN RAMON
Mailing Address - State:CA
Mailing Address - Zip Code:94583-4483
Mailing Address - Country:US
Mailing Address - Phone:925-895-6533
Mailing Address - Fax:
Practice Address - Street 1:302 COUNTRYBROOK LOOP
Practice Address - Street 2:
Practice Address - City:SAN RAMON
Practice Address - State:CA
Practice Address - Zip Code:94583-4483
Practice Address - Country:US
Practice Address - Phone:925-895-6533
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2010-08-04
Last Update Date:2022-01-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA32760225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist