Healthcare Provider Details

I. General information

NPI: 1477260628
Provider Name (Legal Business Name): SARA SHUEY PT, DPT
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: SARA NELSON PT, DPT

II. Dates (important events)

Enumeration Date: 10/27/2022
Last Update Date: 09/26/2023
Certification Date: 09/26/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

331 N 11TH AVE BLDG SUITE
HANFORD CA
93230-4511
US

IV. Provider business mailing address

1155 W JULIA WAY
HANFORD CA
93230-8569
US

V. Phone/Fax

Practice location:
  • Phone: 559-582-1027
  • Fax: 559-582-8105
Mailing address:
  • Phone: 315-591-7791
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2251N0400X
TaxonomyNeurology Physical Therapist
License Number292611
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: