Healthcare Provider Details

I. General information

NPI: 1497467120
Provider Name (Legal Business Name): DHRUVI RAMANBHAI SHAH
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 12/13/2022
Last Update Date: 09/14/2026
Certification Date: 09/14/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1194 S DE ANZA BLVD
SAN JOSE CA
95129-3632
US

IV. Provider business mailing address

7375 ROLLINGDELL DR APT 9
CUPERTINO CA
95014-5827
US

V. Phone/Fax

Practice location:
  • Phone: 408-257-2225
  • Fax:
Mailing address:
  • Phone: 408-431-2059
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License NumberPT61232482
License Number StateWA
# 2
Primary TaxonomyY
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License NumberPT305222
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: