Provider Demographics
NPI:1194865592
Name:RANAWAT, SWETA J (RPT)
Entity type:Individual
Prefix:MRS
First Name:SWETA
Middle Name:J
Last Name:RANAWAT
Suffix:
Gender:F
Credentials:RPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:11670 ALLEN
Mailing Address - Street 2:
Mailing Address - City:TUSTIN
Mailing Address - State:CA
Mailing Address - Zip Code:92782-3324
Mailing Address - Country:US
Mailing Address - Phone:714-914-8268
Mailing Address - Fax:714-368-1066
Practice Address - Street 1:11670 ALLEN
Practice Address - Street 2:
Practice Address - City:TUSTIN
Practice Address - State:CA
Practice Address - Zip Code:92782-3324
Practice Address - Country:US
Practice Address - Phone:714-914-8268
Practice Address - Fax:714-368-1066
Is Sole Proprietor?:Yes
Enumeration Date:2007-02-07
Last Update Date:2018-02-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA27760225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAQ04202Medicare UPIN
CAPT27760Medicare ID - Type Unspecified