Provider Demographics
NPI:1164669602
Name:FITZPATRICK, SANDRA (OTR/L)
Entity Type:Individual
Prefix:
First Name:SANDRA
Middle Name:
Last Name:FITZPATRICK
Suffix:
Gender:F
Credentials:OTR/L
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8 CIGLIANO AISLE
Mailing Address - Street 2:
Mailing Address - City:IRVINE
Mailing Address - State:CA
Mailing Address - Zip Code:92606-8297
Mailing Address - Country:US
Mailing Address - Phone:949-553-8369
Mailing Address - Fax:949-387-2156
Practice Address - Street 1:8 CIGLIANO AISLE
Practice Address - Street 2:
Practice Address - City:IRVINE
Practice Address - State:CA
Practice Address - Zip Code:92606-8297
Practice Address - Country:US
Practice Address - Phone:949-553-8369
Practice Address - Fax:949-387-2156
Is Sole Proprietor?:No
Enumeration Date:2009-01-20
Last Update Date:2009-01-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA273225XP0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225XP0200XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistPediatrics