Provider Demographics
NPI:1457769960
Name:PFAU, SARAH (MS, ATC, CSCS)
Entity Type:Individual
Prefix:
First Name:SARAH
Middle Name:
Last Name:PFAU
Suffix:
Gender:F
Credentials:MS, ATC, CSCS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9806 MADONNA CT
Mailing Address - Street 2:
Mailing Address - City:RANCHO CUCAMONGA
Mailing Address - State:CA
Mailing Address - Zip Code:91730-6242
Mailing Address - Country:US
Mailing Address - Phone:480-338-0266
Mailing Address - Fax:
Practice Address - Street 1:9806 MADONNA CT
Practice Address - Street 2:
Practice Address - City:RANCHO CUCAMONGA
Practice Address - State:CA
Practice Address - Zip Code:91730-6242
Practice Address - Country:US
Practice Address - Phone:480-338-0266
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-07-28
Last Update Date:2014-07-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OR174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist