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General NPI Number Information
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NPI Number | 1235951823
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Entity Type | Individual
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Provider Name | SARA LORELEI MACIAS OTR/L
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Gender | Female
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Dates
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Enumeration Date | 10/25/2024
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Last Update Date | 10/25/2024
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Provider Practice Location Address
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Address Line | 2855 CARLSBAD BLVD
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City | CARLSBAD
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State | CA
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Zip | 92008-2902
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Country | US
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Telephone | 760-720-4580
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 20616
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City | RIVERSIDE
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State | CA
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Zip | 92516-0616
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Country | US
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Telephone | 951-544-6428
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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 | 225X00000X
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Taxonomy Name | Occupational Therapist
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License Number | 27050
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License Number State | CA
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