Healthcare Provider Details

I. General information

NPI: 1235034281
Provider Name (Legal Business Name): PRATICHHYA SHRESTHA
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 10/09/2026
Last Update Date: 10/09/2026
Certification Date: 10/09/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1230 E WINDSOR RD
GLENDALE CA
91205-2656
US

IV. Provider business mailing address

304 N 4TH ST APT F
ALHAMBRA CA
91801-2206
US

V. Phone/Fax

Practice location:
  • Phone: 818-244-7219
  • Fax:
Mailing address:
  • Phone: 562-766-9912
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License Number310698
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: