Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 225100000X | Physical Therapist | 40589 | CA |
N | 2251C2600X | Cardiopulmonary | 40589 | CA |
N | 2251E1200X | Ergonomics | 40589 | CA |
N | 225XE1200X | Ergonomics | 40589 | CA |
N | 2251G0304X | Physical Therapist - Geriatrics | 40589 | CA |
N | 2251N0400X | Physical Therapist - Neurology | 40589 | CA |
N | 2251X0800X | Physical Therapist - Orthopedic | 40589 | CA |
NPI | 1629406335 |
---|---|
Provider Name | Romita Prasad |
First Address | Fremont, CA 94539-7728 |
Second Address | Fremont, CA 94539-7728 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 16/10/2013 |
Last Update Date | 15/10/2020 |