Healthcare Provider Details

I. General information

NPI: 1770849531
Provider Name (Legal Business Name): ALISHA SOHAM JOSHI DPT
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/05/2012
Last Update Date: 11/01/2022
Certification Date: 11/01/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3300 IRVINE AVE. SUITE 130
NEWPORT BEACH CA
92660-3119
US

IV. Provider business mailing address

3230 E IMPERIAL HWY SUITE 100
BREA CA
92821-6735
US

V. Phone/Fax

Practice location:
  • Phone: 949-271-0053
  • Fax: 949-271-9453
Mailing address:
  • Phone: 714-988-8110
  • Fax: 714-988-8111

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License Number034747-1
License Number StateNY
# 2
Primary TaxonomyN
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License Number40QA01603100
License Number StateNJ
# 3
Primary TaxonomyY
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License NumberPT293202
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: