Provider Demographics
NPI:1265795652
Name:HIRAMOTO, SABRINA
Entity type:Individual
Prefix:
First Name:SABRINA
Middle Name:
Last Name:HIRAMOTO
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4650 WEST OAKEY BOULEVARD
Mailing Address - Street 2:APT 1001
Mailing Address - City:LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89102
Mailing Address - Country:US
Mailing Address - Phone:310-339-4884
Mailing Address - Fax:877-533-6140
Practice Address - Street 1:4650 W OAKEY BLVD
Practice Address - Street 2:APT 1001
Practice Address - City:LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89102-1510
Practice Address - Country:US
Practice Address - Phone:310-339-4884
Practice Address - Fax:877-533-6140
Is Sole Proprietor?:Yes
Enumeration Date:2012-06-20
Last Update Date:2012-06-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225400000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersRehabilitation Practitioner