Provider Demographics
NPI:1699426643
Name:PATKI, PRANITA MADHAORAO (MS OTR/L)
Entity type:Individual
Prefix:
First Name:PRANITA
Middle Name:MADHAORAO
Last Name:PATKI
Suffix:
Gender:F
Credentials:MS OTR/L
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:311 RAY ST
Mailing Address - Street 2:
Mailing Address - City:PLEASANTON
Mailing Address - State:CA
Mailing Address - Zip Code:94566-6621
Mailing Address - Country:US
Mailing Address - Phone:925-399-5796
Mailing Address - Fax:925-249-5121
Practice Address - Street 1:311 RAY ST
Practice Address - Street 2:
Practice Address - City:PLEASANTON
Practice Address - State:CA
Practice Address - Zip Code:94566-6621
Practice Address - Country:US
Practice Address - Phone:925-399-5796
Practice Address - Fax:925-249-5121
Is Sole Proprietor?:No
Enumeration Date:2022-01-11
Last Update Date:2022-01-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA14838225XP0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225XP0200XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistPediatrics