Healthcare Provider Details

I. General information

NPI: 1598132813
Provider Name (Legal Business Name): SASHA WANG MOTR/L
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/24/2015
Last Update Date: 08/28/2026
Certification Date: 08/28/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5340 ELVAS AVE STE 300
SACRAMENTO CA
95819-2391
US

IV. Provider business mailing address

8188 TRIPLEFIN WAY
ELK GROVE CA
95757-6452
US

V. Phone/Fax

Practice location:
  • Phone: 916-346-9352
  • Fax:
Mailing address:
  • Phone: 510-382-1188
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225XP0200X
TaxonomyPediatric Occupational Therapist
License Number15085
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: