Provider Demographics
NPI:1861739369
Name:SANDO, TRISHA (DPT)
Entity type:Individual
Prefix:DR
First Name:TRISHA
Middle Name:
Last Name:SANDO
Suffix:
Gender:F
Credentials:DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:260 N OAK AVE APT 12
Mailing Address - Street 2:
Mailing Address - City:PASADENA
Mailing Address - State:CA
Mailing Address - Zip Code:91107-3252
Mailing Address - Country:US
Mailing Address - Phone:626-627-3674
Mailing Address - Fax:
Practice Address - Street 1:260 N OAK AVE APT 12
Practice Address - Street 2:
Practice Address - City:PASADENA
Practice Address - State:CA
Practice Address - Zip Code:91107-3252
Practice Address - Country:US
Practice Address - Phone:626-627-3674
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-01-04
Last Update Date:2013-01-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAPT 30442225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist