Provider Demographics
NPI:1851946032
Name:MEECH, SARAH (PT, DPT)
Entity Type:Individual
Prefix:
First Name:SARAH
Middle Name:
Last Name:MEECH
Suffix:
Gender:F
Credentials:PT, DPT
Other - Prefix:
Other - First Name:SARAH
Other - Middle Name:
Other - Last Name:SHAW
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:PT, DPT
Mailing Address - Street 1:1427 GRANT AVE
Mailing Address - Street 2:
Mailing Address - City:NOVATO
Mailing Address - State:CA
Mailing Address - Zip Code:94945-3118
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:9909 MIRA MESA BLVD STE 260
Practice Address - Street 2:
Practice Address - City:SAN DIEGO
Practice Address - State:CA
Practice Address - Zip Code:92131-1064
Practice Address - Country:US
Practice Address - Phone:858-279-5570
Practice Address - Fax:858-384-1542
Is Sole Proprietor?:Yes
Enumeration Date:2019-08-05
Last Update Date:2021-09-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA297094225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA297094OtherPT LICENSE