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General NPI Number Information
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NPI Number | 1144512112
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Entity Type | Individual
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Provider Name | SARAH FATA
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Gender | Female
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Dates
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Enumeration Date | 05/10/2011
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Last Update Date | 05/10/2011
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Provider Practice Location Address
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Address Line | 13177 RAMONA BLVD STE. C
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City | IRWINDALE
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State | CA
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Zip | 91706-3855
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Country | US
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Telephone | 626-960-4020
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Fax |
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Provider Business Mailing Address
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Address Line | 14814 E. GALE AVE. APT #B13
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City | HACIENDA HEIGHTS
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State | CA
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Zip | 91745
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Country | US
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Telephone | 626-393-8650
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 225400000X
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Taxonomy Name | Rehabilitation Practitioner
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License Number |
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License Number State |
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