Healthcare Provider Details

I. General information

NPI: 1407371685
Provider Name (Legal Business Name): SARAH LYNN CORRELL PT, DPT
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/08/2017
Last Update Date: 01/31/2022
Certification Date: 01/31/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

263 N MATHILDA AVE
SUNNYVALE CA
94086-4830
US

IV. Provider business mailing address

325 DISTEL CIR
LOS ALTOS CA
94022-1408
US

V. Phone/Fax

Practice location:
  • Phone: 408-736-7600
  • Fax:
Mailing address:
  • Phone: 650-853-3355
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License Number293286
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: