Healthcare Provider Details

I. General information

NPI: 1235991225
Provider Name (Legal Business Name): SARAH RAASCH
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 01/25/2024
Last Update Date: 01/25/2024
Certification Date: 01/25/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

433 W BASTANCHURY RD
FULLERTON CA
92835-3404
US

IV. Provider business mailing address

3324 STEVELY AVE
LONG BEACH CA
90808-4405
US

V. Phone/Fax

Practice location:
  • Phone: 714-361-0110
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code225XG0600X
TaxonomyGerontology Occupational Therapist
License Number485526
License Number StateCA
# 2
Primary TaxonomyY
Taxonomy Code225XP0019X
TaxonomyPhysical Rehabilitation Occupational Therapist
License Number485526
License Number StateCA
# 3
Primary TaxonomyN
Taxonomy Code225XE0001X
TaxonomyEnvironmental Modification Occupational Therapist
License Number485526
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: