Provider Demographics
NPI:1891711271
Name:HUMBOLDT HAND AND FOOT THERAPY
Entity Type:Organization
Organization Name:HUMBOLDT HAND AND FOOT THERAPY
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:PATRICK
Authorized Official - Middle Name:
Authorized Official - Last Name:SARABIA
Authorized Official - Suffix:
Authorized Official - Credentials:OTR
Authorized Official - Phone:707-441-1931
Mailing Address - Street 1:1587 MYRTLE AVE
Mailing Address - Street 2:
Mailing Address - City:EUREKA
Mailing Address - State:CA
Mailing Address - Zip Code:95501-1453
Mailing Address - Country:US
Mailing Address - Phone:707-441-1931
Mailing Address - Fax:707-441-1940
Practice Address - Street 1:1587 MYRTLE AVE
Practice Address - Street 2:
Practice Address - City:EUREKA
Practice Address - State:CA
Practice Address - Zip Code:95501-1453
Practice Address - Country:US
Practice Address - Phone:707-441-1931
Practice Address - Fax:707-441-1940
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-07-15
Last Update Date:2016-10-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAZZZ21385ZMedicare PIN
CA4194150001Medicare NSC