Provider Demographics
NPI:1972032480
Name:TREVINO, SARAH ADRIANNA (OTR)
Entity Type:Individual
Prefix:MRS
First Name:SARAH
Middle Name:ADRIANNA
Last Name:TREVINO
Suffix:
Gender:F
Credentials:OTR
Other - Prefix:MS
Other - First Name:SARAH
Other - Middle Name:ADRIANNA
Other - Last Name:DE ANDA
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:OTR
Mailing Address - Street 1:5006 E EXPRESSWAY 83 UNIT B
Mailing Address - Street 2:
Mailing Address - City:MERCEDES
Mailing Address - State:TX
Mailing Address - Zip Code:78570-5009
Mailing Address - Country:US
Mailing Address - Phone:956-565-9300
Mailing Address - Fax:956-565-9686
Practice Address - Street 1:2504 E GRIFFIN PKWY
Practice Address - Street 2:
Practice Address - City:MISSION
Practice Address - State:TX
Practice Address - Zip Code:78572-3348
Practice Address - Country:US
Practice Address - Phone:956-581-7171
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-06-08
Last Update Date:2022-11-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX117822225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX117822OtherTEXAS BOARD OF OCCUPATIONAL THERAPY EXAMINERS