Provider Demographics
NPI:1396573622
Name:VORA, RIDDHI RAMESHBHAI
Entity type:Individual
Prefix:
First Name:RIDDHI RAMESHBHAI
Middle Name:
Last Name:VORA
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1055 E EVELYN AVE APT 9
Mailing Address - Street 2:
Mailing Address - City:SUNNYVALE
Mailing Address - State:CA
Mailing Address - Zip Code:94086-6704
Mailing Address - Country:US
Mailing Address - Phone:925-660-2909
Mailing Address - Fax:
Practice Address - Street 1:2488 DE LA CRUZ BLVD
Practice Address - Street 2:
Practice Address - City:SANTA CLARA
Practice Address - State:CA
Practice Address - Zip Code:95050-2923
Practice Address - Country:US
Practice Address - Phone:669-770-8249
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-07-26
Last Update Date:2024-07-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA305758225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGroup - Single Specialty