Healthcare Provider Details

I. General information

NPI: 1760348734
Provider Name (Legal Business Name): HETABEN PATEL
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 01/02/2026
Last Update Date: 01/02/2026
Certification Date: 01/02/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

13131 LOS CARNEROS CT
RIVERSIDE CA
92503-7143
US

IV. Provider business mailing address

13131 LOS CARNEROS CT
RIVERSIDE CA
92503-7143
US

V. Phone/Fax

Practice location:
  • Phone: 201-920-7931
  • Fax:
Mailing address:
  • Phone: 201-920-7931
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: