Healthcare Provider Details

I. General information

NPI: 1578776464
Provider Name (Legal Business Name): SANDRA DOEHR OTR, CHT
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 05/07/2007
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

770 WASHINGTON ST STE 207
SAN DIEGO CA
92103-2209
US

IV. Provider business mailing address

1804 MCKEE ST UNIT B4
SAN DIEGO CA
92110-1966
US

V. Phone/Fax

Practice location:
  • Phone: 619-299-5000
  • Fax: 619-299-1549
Mailing address:
  • Phone: 619-491-0569
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225XH1200X
TaxonomyHand Occupational Therapist
License Number792
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: