Provider Demographics
NPI:1083941413
Name:CRUZ, SALLIE DURAN (OTR)
Entity Type:Individual
Prefix:MRS
First Name:SALLIE
Middle Name:DURAN
Last Name:CRUZ
Suffix:
Gender:F
Credentials:OTR
Other - Prefix:MISS
Other - First Name:SALLIE
Other - Middle Name:DURAN
Other - Last Name:APOLINAR
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:OTR
Mailing Address - Street 1:7801 RUSH RIVER DR
Mailing Address - Street 2:
Mailing Address - City:SACRAMENTO
Mailing Address - State:CA
Mailing Address - Zip Code:95831-4602
Mailing Address - Country:US
Mailing Address - Phone:916-393-9020
Mailing Address - Fax:
Practice Address - Street 1:7801 RUSH RIVER DR
Practice Address - Street 2:
Practice Address - City:SACRAMENTO
Practice Address - State:CA
Practice Address - Zip Code:95831-4602
Practice Address - Country:US
Practice Address - Phone:916-393-9020
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2009-11-05
Last Update Date:2023-12-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA4538225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist