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General NPI Number Information
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NPI Number | 1407301864
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Entity Type | Individual
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Provider Name | SRUTHI ADUDODLA
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Gender | Female
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Dates
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Enumeration Date | 08/15/2016
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Last Update Date | 10/12/2024
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Provider Practice Location Address
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Address Line | 6320 CANOGA AVE FL 15
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City | WOODLAND HILLS
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State | CA
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Zip | 91367-2563
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Country | US
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Telephone | 818-588-4894
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Fax |
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Provider Business Mailing Address
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Address Line | 6320 CANOGA AVE FL 15
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City | WOODLAND HILLS
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State | CA
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Zip | 91367-2563
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 225100000X
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Taxonomy Name | Physical Therapist
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License Number | PT025129
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License Number State | PA
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Taxonomy #2
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Taxonomy Code | 225100000X
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Taxonomy Name | Physical Therapist
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License Number | J1-0003407
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License Number State | DE
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Taxonomy #3
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Taxonomy Code | 225100000X
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Taxonomy Name | Physical Therapist
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License Number | 296578
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License Number State | CA
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