Provider Demographics
NPI:1770053886
Name:KERR, SABRINA CANEA (BS)
Entity type:Individual
Prefix:
First Name:SABRINA
Middle Name:CANEA
Last Name:KERR
Suffix:
Gender:F
Credentials:BS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:120 36TH ST
Mailing Address - Street 2:
Mailing Address - City:MANHATTAN BEACH
Mailing Address - State:CA
Mailing Address - Zip Code:90266-3202
Mailing Address - Country:US
Mailing Address - Phone:310-658-3171
Mailing Address - Fax:310-295-2402
Practice Address - Street 1:2602 NELSON AVE
Practice Address - Street 2:
Practice Address - City:REDONDO BEACH
Practice Address - State:CA
Practice Address - Zip Code:90278-2613
Practice Address - Country:US
Practice Address - Phone:310-658-3171
Practice Address - Fax:310-295-2402
Is Sole Proprietor?:No
Enumeration Date:2018-12-01
Last Update Date:2018-12-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA3957224Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes224Z00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapy Assistant