Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 225100000X | Physical Therapist | PT27392 | CA |
N | 2251C2600X | Cardiopulmonary | PT27392 | CA |
N | 2251E1200X | Ergonomics | PT27392 | CA |
N | 225XE1200X | Ergonomics | PT27392 | CA |
N | 2251E1300X | Electrophysiology, Clinical | PT27392 | CA |
Y | 2251G0304X | Physical Therapist - Geriatrics | PT27392 | CA |
N | 2251N0400X | Physical Therapist - Neurology | PT273925 | CA |
N | 2251P0200X | Physical Therapist - Pediatrics | PT27392 | CA |
N | 2251S0007X | Physical Therapist - Sports | PT | CA |
N | 2251X0800X | Physical Therapist - Orthopedic | PT27392 | CA |
NPI | 1245372119 |
---|---|
Provider Name | Sara Chavez |
First Address | Mammoth Lakes, CA 93546-0660 |
Second Address | Mammoth Lakes, CA 93546 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 13/02/2007 |
Last Update Date | 21/04/2020 |