Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 225400000X | Rehabilitation Practitioner |
NPI | 1003491721 |
---|---|
Provider Name | Sierra S Salvatierra |
First Address | San Jose, CA 95131-1888 |
Second Address | San Jose, CA 95131-1888 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 15/03/2021 |
Last Update Date | 17/03/2021 |