Provider Demographics
NPI:1922295401
Name:RUTSTEIN, SANDRA GAIL (OTR,L)
Entity Type:Individual
Prefix:MISS
First Name:SANDRA
Middle Name:GAIL
Last Name:RUTSTEIN
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 1:191 S OAK PARK BLVD STE 9
Mailing Address - Street 2:
Mailing Address - City:GROVER BEACH
Mailing Address - State:CA
Mailing Address - Zip Code:93433-2265
Mailing Address - Country:US
Mailing Address - Phone:805-474-6811
Mailing Address - Fax:805-668-2290
Practice Address - Street 1:191 S OAK PARK BLVD STE 9
Practice Address - Street 2:
Practice Address - City:GROVER BEACH
Practice Address - State:CA
Practice Address - Zip Code:93433-2265
Practice Address - Country:US
Practice Address - Phone:805-474-6811
Practice Address - Fax:805-668-2290
Is Sole Proprietor?:Yes
Enumeration Date:2007-09-28
Last Update Date:2024-02-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAOT4777225XP0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225XP0200XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistPediatrics