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General NPI Number Information
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NPI Number | 1558043620
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Entity Type | Individual
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Provider Name | SARAH MENDENHALL DPT
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Gender | Female
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Dates
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Enumeration Date | 08/07/2023
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Last Update Date | 08/07/2023
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Provider Practice Location Address
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Address Line | 1601 KETTNER BLVD UNIT 11
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City | SAN DIEGO
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State | CA
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Zip | 92101-2539
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Country | US
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Telephone | 619-544-1055
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Fax |
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Provider Business Mailing Address
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Address Line | 14915 HEATHER DR
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City | SAN JOSE
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State | CA
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Zip | 95124-5511
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Country | US
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Telephone | 408-838-7644
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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 | 225100000X
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Taxonomy Name | Physical Therapist
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License Number | PT304493
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License Number State | CA
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