Provider Demographics
NPI:1790114908
Name:JIAO, SABINE ROCIO MENDEZONA (MS, OTR/L)
Entity Type:Individual
Prefix:MRS
First Name:SABINE
Middle Name:ROCIO MENDEZONA
Last Name:JIAO
Suffix:
Gender:F
Credentials:MS, OTR/L
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:25 POST ST
Mailing Address - Street 2:
Mailing Address - City:SAN JOSE
Mailing Address - State:CA
Mailing Address - Zip Code:95113-2411
Mailing Address - Country:US
Mailing Address - Phone:408-484-1028
Mailing Address - Fax:
Practice Address - Street 1:25 POST ST
Practice Address - Street 2:
Practice Address - City:SAN JOSE
Practice Address - State:CA
Practice Address - Zip Code:95113-2411
Practice Address - Country:US
Practice Address - Phone:408-484-1028
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2013-11-07
Last Update Date:2013-11-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA2478225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist