Healthcare Provider Details

I. General information

NPI: 1225595291
Provider Name (Legal Business Name): GRISHMA GALA
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 02/26/2019
Last Update Date: 02/26/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2500 COUNTRY DR
FREMONT CA
94536-5356
US

IV. Provider business mailing address

1151 KIELY BLVD
SANTA CLARA CA
95051-3820
US

V. Phone/Fax

Practice location:
  • Phone: 510-792-4242
  • Fax:
Mailing address:
  • Phone: 412-320-6206
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225X00000X
TaxonomyOccupational Therapist
License Number
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: