Provider Demographics
NPI:1932125010
Name:WALKER, SARA E
Entity Type:Individual
Prefix:
First Name:SARA
Middle Name:E
Last Name:WALKER
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:SARA
Other - Middle Name:E
Other - Last Name:WALKER
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:OTR, CHT
Mailing Address - Street 1:16 ELLENWOOD AVE
Mailing Address - Street 2:
Mailing Address - City:LOS GATOS
Mailing Address - State:CA
Mailing Address - Zip Code:95030-5210
Mailing Address - Country:US
Mailing Address - Phone:408-377-2696
Mailing Address - Fax:408-377-1692
Practice Address - Street 1:3880 S BASCOM AVE
Practice Address - Street 2:SUITE 207
Practice Address - City:SAN JOSE
Practice Address - State:CA
Practice Address - Zip Code:95124-2674
Practice Address - Country:US
Practice Address - Phone:408-377-2696
Practice Address - Fax:408-377-1692
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-14
Last Update Date:2017-11-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAOT 2747225000000X, 225XE1200X, 225XH1200X, 225XH1300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225XH1200XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistHand
No225000000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOrthotic Fitter
No225XE1200XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistErgonomics
No225XH1300XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistHuman Factors
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAZZZ28381ZMedicare PIN
CAZZZ28381ZMedicare ID - Type UnspecifiedMEDICARE PROVIDER NUMBER
CA5263390001Medicare NSC