Provider Demographics
NPI:1124427430
Name:SAMASTA SERVICES INC
Entity type:Organization
Organization Name:SAMASTA SERVICES INC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:PREETHA
Authorized Official - Middle Name:
Authorized Official - Last Name:NAIR
Authorized Official - Suffix:
Authorized Official - Credentials:PT
Authorized Official - Phone:510-825-2505
Mailing Address - Street 1:34278 LENNOX CT
Mailing Address - Street 2:
Mailing Address - City:FREMONT
Mailing Address - State:CA
Mailing Address - Zip Code:94555-2132
Mailing Address - Country:US
Mailing Address - Phone:510-825-2505
Mailing Address - Fax:
Practice Address - Street 1:2805 WHIPPLE RD
Practice Address - Street 2:
Practice Address - City:UNION CITY
Practice Address - State:CA
Practice Address - Zip Code:94587-1233
Practice Address - Country:US
Practice Address - Phone:510-441-8906
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-08-22
Last Update Date:2022-08-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA28422225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGroup - Single Specialty