Provider Demographics
NPI:1063545812
Name:ITOW, SACHI K (MPT)
Entity type:Individual
Prefix:MRS
First Name:SACHI
Middle Name:K
Last Name:ITOW
Suffix:
Gender:F
Credentials:MPT
Other - Prefix:MS
Other - First Name:SACHI
Other - Middle Name:
Other - Last Name:KUWANO
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:MPT
Mailing Address - Street 1:10050 N WOLFE RD
Mailing Address - Street 2:SW 1-190
Mailing Address - City:CUPERTINO
Mailing Address - State:CA
Mailing Address - Zip Code:95014-2519
Mailing Address - Country:US
Mailing Address - Phone:408-236-6174
Mailing Address - Fax:
Practice Address - Street 1:10050 N WOLFE RD
Practice Address - Street 2:SW 1-190
Practice Address - City:CUPERTINO
Practice Address - State:CA
Practice Address - Zip Code:95014-2519
Practice Address - Country:US
Practice Address - Phone:408-236-6174
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-03-13
Last Update Date:2022-01-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA21239225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA21239OtherPT LICENSE