Healthcare Provider Details

I. General information

NPI: 1427559640
Provider Name (Legal Business Name): SHWETA CHHEDA
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 02/22/2018
Last Update Date: 02/13/2025
Certification Date: 02/13/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1031 AVENIDA PICO
SAN CLEMENTE CA
92673-6352
US

IV. Provider business mailing address

24846 LAGRIMA
MISSION VIEJO CA
92692-2327
US

V. Phone/Fax

Practice location:
  • Phone: 949-388-8788
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License Number
License Number StateNULL
# 2
Primary TaxonomyY
Taxonomy Code2251P0200X
TaxonomyPediatric Physical Therapist
License Number
License Number StateNULL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: