Provider Demographics
NPI:1255490785
Name:SPURR, SARAH E (PTA)
Entity Type:Individual
Prefix:MS
First Name:SARAH
Middle Name:E
Last Name:SPURR
Suffix:
Gender:F
Credentials:PTA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:13530 LEADWELL ST APT 8
Mailing Address - Street 2:
Mailing Address - City:VAN NUYS
Mailing Address - State:CA
Mailing Address - Zip Code:91405-2760
Mailing Address - Country:US
Mailing Address - Phone:818-340-8320
Mailing Address - Fax:
Practice Address - Street 1:13530 LEADWELL ST APT 8
Practice Address - Street 2:
Practice Address - City:VAN NUYS
Practice Address - State:CA
Practice Address - Zip Code:91405-2760
Practice Address - Country:US
Practice Address - Phone:818-340-8320
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-12-08
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAAPT3679225200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225200000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapy Assistant
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAAPT3679OtherPHYSICAL THERAPY ASSISTAN