=====================================================
General NPI Number Information
=====================================================
NPI Number | 1932125010
-----------------------------------------------------
Entity Type | Individual
-----------------------------------------------------
Provider Name | SARA E WALKER
-----------------------------------------------------
Gender | Female
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 07/14/2006
-----------------------------------------------------
Last Update Date | 11/27/2017
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 3880 S BASCOM AVE SUITE 207
-----------------------------------------------------
City | SAN JOSE
-----------------------------------------------------
State | CA
-----------------------------------------------------
Zip | 95124-2674
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 408-377-2696
-----------------------------------------------------
Fax | 408-377-1692
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 16 ELLENWOOD AVE
-----------------------------------------------------
City | LOS GATOS
-----------------------------------------------------
State | CA
-----------------------------------------------------
Zip | 95030-5210
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 408-377-2696
-----------------------------------------------------
Fax | 408-377-1692
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position |
-----------------------------------------------------
Name |
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone |
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 225000000X
-----------------------------------------------------
Taxonomy Name | Orthotic Fitter
-----------------------------------------------------
License Number | OT 2747
-----------------------------------------------------
License Number State | CA
-----------------------------------------------------
Taxonomy #2
-----------------------------------------------------
Taxonomy Code | 225XE1200X
-----------------------------------------------------
Taxonomy Name | Ergonomics Occupational Therapist
-----------------------------------------------------
License Number | OT 2747
-----------------------------------------------------
License Number State | CA
-----------------------------------------------------
Taxonomy #3
-----------------------------------------------------
Taxonomy Code | 225XH1200X
-----------------------------------------------------
Taxonomy Name | Hand Occupational Therapist
-----------------------------------------------------
License Number | OT 2747
-----------------------------------------------------
License Number State | CA
-----------------------------------------------------
Taxonomy #4
-----------------------------------------------------
Taxonomy Code | 225XH1300X
-----------------------------------------------------
Taxonomy Name | Human Factors Occupational Therapist
-----------------------------------------------------
License Number | OT 2747
-----------------------------------------------------
License Number State | CA
-----------------------------------------------------