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General NPI Number Information
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NPI Number | 1770380545
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Entity Type | Individual
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Provider Name | NIKITA PATEL PT
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Gender | Female
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Dates
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Enumeration Date | 02/27/2025
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Last Update Date | 02/27/2025
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Provider Practice Location Address
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Address Line | 835 C ST STE 130
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City | GALT
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State | CA
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Zip | 95632-2802
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Country | US
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Telephone | 209-745-5802
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Fax | 209-745-5574
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Provider Business Mailing Address
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Address Line | 408 HIGUERA ST STE 200
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City | SAN LUIS OBISPO
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State | CA
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Zip | 93401-6135
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Country | US
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Telephone | 805-788-0805
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Fax | 805-788-0845
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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 | PT307736
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License Number State | CA
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