Healthcare Provider Details

I. General information

NPI: 1548398464
Provider Name (Legal Business Name): SARAH CHRISTINE BARNES
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 03/01/2007
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

215 W CALIFORNIA AVE
VISTA CA
92083-3622
US

IV. Provider business mailing address

6951 PEACH TREE RD
CARLSBAD CA
92011-3935
US

V. Phone/Fax

Practice location:
  • Phone: 760-724-0831
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2251P0200X
TaxonomyPediatric Physical Therapist
License Number33467
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: