Healthcare Provider Details

I. General information

NPI: 1255689774
Provider Name (Legal Business Name): SHERRI K SZABO PT
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/15/2012
Last Update Date: 08/15/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

525 MELISSA AVE SUITE B
BARSTOW CA
92311-3002
US

IV. Provider business mailing address

525 MELISSA AVE SUITE B
BARSTOW CA
92311-3002
US

V. Phone/Fax

Practice location:
  • Phone: 760-256-1888
  • Fax: 760-256-2893
Mailing address:
  • Phone: 760-256-1888
  • Fax: 760-256-2893

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License NumberPT38776
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: