Provider Demographics
NPI:1053088906
Name:ROBERTS, SARAH (PT, DPT, CSCS)
Entity Type:Individual
Prefix:
First Name:SARAH
Middle Name:
Last Name:ROBERTS
Suffix:
Gender:F
Credentials:PT, DPT, CSCS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:696 WHITING ST
Mailing Address - Street 2:
Mailing Address - City:GRASS VALLEY
Mailing Address - State:CA
Mailing Address - Zip Code:95945-7543
Mailing Address - Country:US
Mailing Address - Phone:530-777-5605
Mailing Address - Fax:
Practice Address - Street 1:696 WHITING ST
Practice Address - Street 2:
Practice Address - City:GRASS VALLEY
Practice Address - State:CA
Practice Address - Zip Code:95945-7543
Practice Address - Country:US
Practice Address - Phone:530-777-5605
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-08-27
Last Update Date:2023-11-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA300642208100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208100000XAllopathic & Osteopathic PhysiciansPhysical Medicine & Rehabilitation