Healthcare Provider Details

I. General information

NPI: 1164186763
Provider Name (Legal Business Name): CS PHYSICAL THERAPY CORPORATION
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/29/2021
Last Update Date: 05/13/2025
Certification Date: 05/13/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1026 MONROE ST
SANTA CLARA CA
95050-4811
US

IV. Provider business mailing address

2337 FOREST AVE
SAN JOSE CA
95128-4606
US

V. Phone/Fax

Practice location:
  • Phone: 408-246-5861
  • Fax: 408-246-2066
Mailing address:
  • Phone: 408-246-5861
  • Fax: 408-246-2066

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code261QP2000X
TaxonomyPhysical Therapy Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: CRAIG MITSUTO SHIRAISHI
Title or Position: OWNER
Credential: DPT
Phone: 408-246-5861