Provider Demographics
NPI:1265076228
Name:ARATA, SANDI MICHELLE (PT)
Entity type:Individual
Prefix:
First Name:SANDI
Middle Name:MICHELLE
Last Name:ARATA
Suffix:
Gender:F
Credentials:PT
Other - Prefix:
Other - First Name:SANDI
Other - Middle Name:MICHELLE
Other - Last Name:NELSON
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PT
Mailing Address - Street 1:1969 PALM AVE
Mailing Address - Street 2:
Mailing Address - City:SAN MATEO
Mailing Address - State:CA
Mailing Address - Zip Code:94403-1326
Mailing Address - Country:US
Mailing Address - Phone:425-941-9844
Mailing Address - Fax:
Practice Address - Street 1:101 LINCOLN AVE
Practice Address - Street 2:
Practice Address - City:DALY CITY
Practice Address - State:CA
Practice Address - Zip Code:94015-3997
Practice Address - Country:US
Practice Address - Phone:650-991-1000
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-11-03
Last Update Date:2019-11-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA30179225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist