Provider Demographics
NPI:1891534624
Name:FONG, SARAH (DPT)
Entity type:Individual
Prefix:
First Name:SARAH
Middle Name:
Last Name:FONG
Suffix:
Gender:F
Credentials:DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1270 CLARKE LN
Mailing Address - Street 2:
Mailing Address - City:ALAMEDA
Mailing Address - State:CA
Mailing Address - Zip Code:94502-7603
Mailing Address - Country:US
Mailing Address - Phone:510-695-1053
Mailing Address - Fax:
Practice Address - Street 1:39650 LIBERTY ST STE 140
Practice Address - Street 2:
Practice Address - City:FREMONT
Practice Address - State:CA
Practice Address - Zip Code:94538-2225
Practice Address - Country:US
Practice Address - Phone:510-498-3900
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-05-21
Last Update Date:2024-05-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist