Provider Demographics
NPI:1033949847
Name:NIEVES, SARA KARINA (DPT)
Entity type:Individual
Prefix:
First Name:SARA
Middle Name:KARINA
Last Name:NIEVES
Suffix:
Gender:F
Credentials:DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3455 ADAMS AVE UNIT 2
Mailing Address - Street 2:
Mailing Address - City:SAN DIEGO
Mailing Address - State:CA
Mailing Address - Zip Code:92116-2433
Mailing Address - Country:US
Mailing Address - Phone:619-454-2466
Mailing Address - Fax:
Practice Address - Street 1:3750 CONVOY ST STE 201B
Practice Address - Street 2:
Practice Address - City:SAN DIEGO
Practice Address - State:CA
Practice Address - Zip Code:92111-3738
Practice Address - Country:US
Practice Address - Phone:858-302-2499
Practice Address - Fax:858-302-2501
Is Sole Proprietor?:Yes
Enumeration Date:2024-08-06
Last Update Date:2024-08-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist