Provider Demographics
NPI:1417177833
Name:ALLEY, SABRINA DANIELLE (CMT,MMT)
Entity type:Individual
Prefix:
First Name:SABRINA
Middle Name:DANIELLE
Last Name:ALLEY
Suffix:
Gender:F
Credentials:CMT,MMT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:9108 LAGUNA MAIN ST
Mailing Address - Street 2:SUITE 1A
Mailing Address - City:ELK GROVE
Mailing Address - State:CA
Mailing Address - Zip Code:95758-7450
Mailing Address - Country:US
Mailing Address - Phone:916-421-4117
Mailing Address - Fax:916-691-9503
Practice Address - Street 1:9108 LAGUNA MAIN ST
Practice Address - Street 2:SUITE 1A
Practice Address - City:ELK GROVE
Practice Address - State:CA
Practice Address - Zip Code:95758-7450
Practice Address - Country:US
Practice Address - Phone:916-421-4117
Practice Address - Fax:916-691-9503
Is Sole Proprietor?:Yes
Enumeration Date:2007-04-26
Last Update Date:2013-03-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA628255225700000X
CA2012-00745225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist