Healthcare Provider Details

I. General information

NPI: 1780523738
Provider Name (Legal Business Name): TRISHA NEWAZ
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 03/26/2026
Last Update Date: 03/26/2026
Certification Date: 03/26/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

10 TERRACINA BLVD
REDLANDS CA
92373-4808
US

IV. Provider business mailing address

3604 SHANDIN CIR
SAN BERNARDINO CA
92407-4311
US

V. Phone/Fax

Practice location:
  • Phone: 909-793-8691
  • Fax:
Mailing address:
  • Phone: 818-259-1804
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225X00000X
TaxonomyOccupational Therapist
License Number22673
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: