Provider Demographics
NPI:1316697634
Name:SAECHAO, ARIANA V (NMT, CMT)
Entity type:Individual
Prefix:
First Name:ARIANA
Middle Name:V
Last Name:SAECHAO
Suffix:
Gender:F
Credentials:NMT, CMT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2824 REGATTA BLVD
Mailing Address - Street 2:
Mailing Address - City:RICHMOND
Mailing Address - State:CA
Mailing Address - Zip Code:94804
Mailing Address - Country:US
Mailing Address - Phone:510-334-0308
Mailing Address - Fax:
Practice Address - Street 1:2824 REGATTA BLVD
Practice Address - Street 2:
Practice Address - City:RICHMOND
Practice Address - State:CA
Practice Address - Zip Code:94804
Practice Address - Country:US
Practice Address - Phone:510-334-0308
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-03-28
Last Update Date:2022-03-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA78221204C00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes204C00000XAllopathic & Osteopathic PhysiciansNeuromusculoskeletal Medicine, Sports MedicineGroup - Multi-Specialty