Healthcare Provider Details

I. General information

NPI: 1932125010
Provider Name (Legal Business Name): SARA E WALKER
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

Provider Other Name: SARA E WALKER O.T.R., C.H.T.

II. Dates (important events)

Enumeration Date: 07/14/2006
Last Update Date: 11/27/2017
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3880 S BASCOM AVE SUITE 207
SAN JOSE CA
95124-2674
US

IV. Provider business mailing address

16 ELLENWOOD AVE
LOS GATOS CA
95030-5210
US

V. Phone/Fax

Practice location:
  • Phone: 408-377-2696
  • Fax: 408-377-1692
Mailing address:
  • Phone: 408-377-2696
  • Fax: 408-377-1692

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code225000000X
TaxonomyOrthotic Fitter
License NumberOT 2747
License Number StateCA
# 2
Primary TaxonomyN
Taxonomy Code225XE1200X
TaxonomyErgonomics Occupational Therapist
License NumberOT 2747
License Number StateCA
# 3
Primary TaxonomyY
Taxonomy Code225XH1200X
TaxonomyHand Occupational Therapist
License NumberOT 2747
License Number StateCA
# 4
Primary TaxonomyN
Taxonomy Code225XH1300X
TaxonomyHuman Factors Occupational Therapist
License NumberOT 2747
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: