Provider Demographics
NPI:1245431261
Name:BLACKNEY, SABRINA LEE (DPT)
Entity Type:Individual
Prefix:
First Name:SABRINA
Middle Name:LEE
Last Name:BLACKNEY
Suffix:
Gender:F
Credentials:DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2850 RED HILL AVE
Mailing Address - Street 2:SUITE 230
Mailing Address - City:SANTA ANA
Mailing Address - State:CA
Mailing Address - Zip Code:92705-5532
Mailing Address - Country:US
Mailing Address - Phone:949-251-1975
Mailing Address - Fax:
Practice Address - Street 1:2850 RED HILL AVE
Practice Address - Street 2:SUITE 230
Practice Address - City:SANTA ANA
Practice Address - State:CA
Practice Address - Zip Code:92705-5532
Practice Address - Country:US
Practice Address - Phone:949-251-1975
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-29
Last Update Date:2011-06-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA33717225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist