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General NPI Number Information
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NPI Number | 1942688478
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Entity Type | Individual
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Provider Name | LALEH EBADAT
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Gender | Female
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Dates
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Enumeration Date | 05/17/2015
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Last Update Date | 09/14/2025
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Provider Practice Location Address
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Address Line | 6489 CAMDEN AVE
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City | SAN JOSE
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State | CA
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Zip | 95120-2849
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Country | US
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Telephone | 408-268-0600
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Fax |
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Provider Business Mailing Address
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Address Line | 6217 VALROY DR
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City | SAN JOSE
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State | CA
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Zip | 95123-4952
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Country | US
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Telephone | 408-438-3946
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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 | 33907
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License Number State | CA
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