Provider Demographics
NPI:1881659373
Name:DIXON, SALLY B (OTR/MS)
Entity Type:Individual
Prefix:
First Name:SALLY
Middle Name:B
Last Name:DIXON
Suffix:
Gender:F
Credentials:OTR/MS
Other - Prefix:
Other - First Name:SALLY
Other - Middle Name:B
Other - Last Name:CHEW
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:998 GOLD NUGGET CIR
Mailing Address - Street 2:
Mailing Address - City:LINCOLN
Mailing Address - State:CA
Mailing Address - Zip Code:95648-8337
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:998 GOLD NUGGET CIR
Practice Address - Street 2:
Practice Address - City:LINCOLN
Practice Address - State:CA
Practice Address - Zip Code:95648-8337
Practice Address - Country:US
Practice Address - Phone:916-408-1003
Practice Address - Fax:
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-04-19
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA2517225XH1200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225XH1200XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistHand