Provider Demographics
NPI:1689059933
Name:HOWERTON, SANDRA LU (PT)
Entity Type:Individual
Prefix:MRS
First Name:SANDRA
Middle Name:LU
Last Name:HOWERTON
Suffix:
Gender:F
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:383 GOLDEN VINE CT
Mailing Address - Street 2:
Mailing Address - City:SIMI VALLEY
Mailing Address - State:CA
Mailing Address - Zip Code:93065-6705
Mailing Address - Country:US
Mailing Address - Phone:805-581-2335
Mailing Address - Fax:
Practice Address - Street 1:607 ELMIRA RD
Practice Address - Street 2:SUITE 239
Practice Address - City:VACAVILLE
Practice Address - State:CA
Practice Address - Zip Code:95687-4655
Practice Address - Country:US
Practice Address - Phone:805-581-2335
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2015-07-29
Last Update Date:2015-07-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA13488225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist