Provider Demographics
NPI:1023635463
Name:SAHAGUN, NACIRA (OTD, OTR/L)
Entity type:Individual
Prefix:
First Name:NACIRA
Middle Name:
Last Name:SAHAGUN
Suffix:
Gender:F
Credentials:OTD, OTR/L
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:342 S 14TH ST
Mailing Address - Street 2:
Mailing Address - City:GROVER BEACH
Mailing Address - State:CA
Mailing Address - Zip Code:93433-2537
Mailing Address - Country:US
Mailing Address - Phone:805-407-6486
Mailing Address - Fax:
Practice Address - Street 1:621 W MICHELTORENA ST STE B
Practice Address - Street 2:
Practice Address - City:SANTA BARBARA
Practice Address - State:CA
Practice Address - Zip Code:93101-4195
Practice Address - Country:US
Practice Address - Phone:805-253-2547
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-07-01
Last Update Date:2020-07-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA20515225XP0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225XP0200XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistPediatrics