Provider Demographics
NPI:1770862120
Name:WEBB, SANDRA (OTR/L)
Entity Type:Individual
Prefix:
First Name:SANDRA
Middle Name:
Last Name:WEBB
Suffix:
Gender:F
Credentials:OTR/L
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2030 KUOLA PL
Mailing Address - Street 2:
Mailing Address - City:HONOLULU
Mailing Address - State:HI
Mailing Address - Zip Code:96821-2607
Mailing Address - Country:US
Mailing Address - Phone:310-925-1211
Mailing Address - Fax:
Practice Address - Street 1:2030 KUOLA PL
Practice Address - Street 2:
Practice Address - City:HONOLULU
Practice Address - State:HI
Practice Address - Zip Code:96821-2607
Practice Address - Country:US
Practice Address - Phone:310-925-1211
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-08-16
Last Update Date:2017-01-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA5159225X00000X
HI1168225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist