Healthcare Provider Details

I. General information

NPI: 1518271378
Provider Name (Legal Business Name): RAICHEL MARY CHERIAN PT
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

Provider Other Name: RAICHEL MARY THOMAS PT

II. Dates (important events)

Enumeration Date: 08/03/2010
Last Update Date: 08/17/2026
Certification Date: 08/17/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

414 TENNESSEE ST
REDLANDS CA
92373-8163
US

IV. Provider business mailing address

30357 MISSION ST
HIGHLAND CA
92346-6322
US

V. Phone/Fax

Practice location:
  • Phone: 310-270-7380
  • Fax:
Mailing address:
  • Phone: 310-270-7380
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code174400000X
TaxonomySpecialist
License NumberPT 32109
License Number StateCA
# 2
Primary TaxonomyY
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License NumberPT32109
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: