Provider Demographics
NPI:1851780142
Name:CARROLL, SARA
Entity type:Individual
Prefix:
First Name:SARA
Middle Name:
Last Name:CARROLL
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1265 FURUKAWA WAY
Mailing Address - Street 2:
Mailing Address - City:SANTA MARIA
Mailing Address - State:CA
Mailing Address - Zip Code:93458-4929
Mailing Address - Country:US
Mailing Address - Phone:805-614-4940
Mailing Address - Fax:805-617-0179
Practice Address - Street 1:1265 FURUKAWA WAY
Practice Address - Street 2:
Practice Address - City:SANTA MARIA
Practice Address - State:CA
Practice Address - Zip Code:93458-4929
Practice Address - Country:US
Practice Address - Phone:805-614-4940
Practice Address - Fax:805-617-0179
Is Sole Proprietor?:No
Enumeration Date:2015-01-09
Last Update Date:2025-05-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225400000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersRehabilitation Practitioner
Provider Identifiers
StateIdentifier IDID TypeIssuer
1316192149OtherSANTA MARIA ACT