Healthcare Provider Details

I. General information

NPI: 1700477817
Provider Name (Legal Business Name): SARAH ILENE SEGURA
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 02/01/2021
Last Update Date: 06/15/2026
Certification Date: 06/15/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

14140 BEACH BLVD STE 223
WESTMINSTER CA
92683-4453
US

IV. Provider business mailing address

15423 HALCOURT AVE
NORWALK CA
90650-5413
US

V. Phone/Fax

Practice location:
  • Phone: 714-896-7519
  • Fax:
Mailing address:
  • Phone: 562-412-4344
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225400000X
TaxonomyRehabilitation Practitioner
License Number
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: