Provider Demographics
NPI:1629784624
Name:GEISLER, SASHA
Entity Type:Individual
Prefix:
First Name:SASHA
Middle Name:
Last Name:GEISLER
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1036 ROSITA RD
Mailing Address - Street 2:
Mailing Address - City:DEL REY OAKS
Mailing Address - State:CA
Mailing Address - Zip Code:93940-5620
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:445 RESERVATION RD STE F
Practice Address - Street 2:
Practice Address - City:MARINA
Practice Address - State:CA
Practice Address - Zip Code:93933-3301
Practice Address - Country:US
Practice Address - Phone:831-583-8747
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-01-24
Last Update Date:2023-02-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAPT38943225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist