Provider Demographics
NPI:1508602426
Name:SAKELLARIOU, MARISA (OTL)
Entity type:Individual
Prefix:
First Name:MARISA
Middle Name:
Last Name:SAKELLARIOU
Suffix:
Gender:F
Credentials:OTL
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:709 SAN MARINO CT
Mailing Address - Street 2:
Mailing Address - City:EL DORADO HILLS
Mailing Address - State:CA
Mailing Address - Zip Code:95762-9683
Mailing Address - Country:US
Mailing Address - Phone:415-272-6580
Mailing Address - Fax:
Practice Address - Street 1:2020 TOWN CENTER WEST WAY
Practice Address - Street 2:
Practice Address - City:EL DORADO HILLS
Practice Address - State:CA
Practice Address - Zip Code:95762-7575
Practice Address - Country:US
Practice Address - Phone:916-975-9866
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-07-02
Last Update Date:2024-07-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist