Provider Demographics
NPI:1104317742
Name:SAWANT, SNEHA (PT)
Entity type:Individual
Prefix:
First Name:SNEHA
Middle Name:
Last Name:SAWANT
Suffix:
Gender:F
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:619 N SAN MATEO DR APT 104
Mailing Address - Street 2:
Mailing Address - City:SAN MATEO
Mailing Address - State:CA
Mailing Address - Zip Code:94401-2344
Mailing Address - Country:US
Mailing Address - Phone:269-532-2417
Mailing Address - Fax:
Practice Address - Street 1:600 SAND HILL RD
Practice Address - Street 2:
Practice Address - City:PALO ALTO
Practice Address - State:CA
Practice Address - Zip Code:94304-2630
Practice Address - Country:US
Practice Address - Phone:650-576-9563
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-05-18
Last Update Date:2018-05-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI5501014658225100000X
CA42053225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist