Healthcare Provider Details

I. General information

NPI: 1932586690
Provider Name (Legal Business Name): SARAH COOK OT
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 05/01/2015
Last Update Date: 05/01/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

27 LOS CERROS AVE
WALNUT CREEK CA
94598-3134
US

IV. Provider business mailing address

27 LOS CERROS AVE
WALNUT CREEK CA
94598-3134
US

V. Phone/Fax

Practice location:
  • Phone: 415-205-0165
  • Fax:
Mailing address:
  • Phone: 415-205-0165
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225XN1300X
TaxonomyNeurorehabilitation Occupational Therapist
License Number9538
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: