Provider Demographics
NPI:1386243624
Name:GARCIA, SANDRA JAMZIN (OTR/L)
Entity type:Individual
Prefix:
First Name:SANDRA
Middle Name:JAMZIN
Last Name:GARCIA
Suffix:
Gender:F
Credentials:OTR/L
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4622 HAMILTON ST APT 5
Mailing Address - Street 2:
Mailing Address - City:SAN DIEGO
Mailing Address - State:CA
Mailing Address - Zip Code:92116-6020
Mailing Address - Country:US
Mailing Address - Phone:562-677-6186
Mailing Address - Fax:
Practice Address - Street 1:260 E CHASE AVE STE NO204
Practice Address - Street 2:
Practice Address - City:EL CAJON
Practice Address - State:CA
Practice Address - Zip Code:92020-6325
Practice Address - Country:US
Practice Address - Phone:619-647-6157
Practice Address - Fax:858-997-2088
Is Sole Proprietor?:No
Enumeration Date:2020-10-19
Last Update Date:2020-10-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAOT21464225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist