Provider Demographics
NPI:1538450127
Name:WENZEL, SARAH ELIZABETH (CPO)
Entity type:Individual
Prefix:MRS
First Name:SARAH
Middle Name:ELIZABETH
Last Name:WENZEL
Suffix:
Gender:F
Credentials:CPO
Other - Prefix:MS
Other - First Name:SARAH
Other - Middle Name:ELIZABETH
Other - Last Name:CARR
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:CPO
Mailing Address - Street 1:88 ROWLAND WAY
Mailing Address - Street 2:SUITE 175
Mailing Address - City:NOVATO
Mailing Address - State:CA
Mailing Address - Zip Code:94945-5042
Mailing Address - Country:US
Mailing Address - Phone:415-892-1502
Mailing Address - Fax:415-892-1907
Practice Address - Street 1:88 ROWLAND WAY
Practice Address - Street 2:SUITE 175
Practice Address - City:NOVATO
Practice Address - State:CA
Practice Address - Zip Code:94945-5042
Practice Address - Country:US
Practice Address - Phone:415-892-1502
Practice Address - Fax:415-892-1907
Is Sole Proprietor?:No
Enumeration Date:2011-04-29
Last Update Date:2013-01-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAOI60223048222Z00000X
WAPS60223055224P00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes222Z00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOrthotist
No224P00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersProsthetist