Provider Demographics
NPI:1609259746
Name:BARTLETT, SARA LYNN (ATC)
Entity type:Individual
Prefix:
First Name:SARA
Middle Name:LYNN
Last Name:BARTLETT
Suffix:
Gender:F
Credentials:ATC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3024 E CRAIG DR
Mailing Address - Street 2:
Mailing Address - City:ORANGE
Mailing Address - State:CA
Mailing Address - Zip Code:92869-4740
Mailing Address - Country:US
Mailing Address - Phone:714-305-7910
Mailing Address - Fax:
Practice Address - Street 1:3024 E CRAIG DR
Practice Address - Street 2:
Practice Address - City:ORANGE
Practice Address - State:CA
Practice Address - Zip Code:92869-4740
Practice Address - Country:US
Practice Address - Phone:714-305-7910
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2015-07-07
Last Update Date:2015-07-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA20000155392255A2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2255A2300XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersSpecialist/TechnologistAthletic Trainer