Provider Demographics
NPI:1730621475
Name:DEVNANI, HEMA
Entity type:Individual
Prefix:
First Name:HEMA
Middle Name:
Last Name:DEVNANI
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 1:351 S FULLER AVE
Mailing Address - Street 2:APT 2G
Mailing Address - City:LOS ANGELES
Mailing Address - State:CA
Mailing Address - Zip Code:90036-5451
Mailing Address - Country:US
Mailing Address - Phone:972-658-4834
Mailing Address - Fax:
Practice Address - Street 1:5450 W PICO BLVD
Practice Address - Street 2:SUITE 202
Practice Address - City:LOS ANGELES
Practice Address - State:CA
Practice Address - Zip Code:90019-3994
Practice Address - Country:US
Practice Address - Phone:818-894-2273
Practice Address - Fax:805-823-6525
Is Sole Proprietor?:No
Enumeration Date:2016-11-11
Last Update Date:2016-11-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA41027225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist