Provider Demographics
NPI:1730070046
Name:GRAVATT, SARAH (OTD)
Entity type:Individual
Prefix:
First Name:SARAH
Middle Name:
Last Name:GRAVATT
Suffix:
Gender:F
Credentials:OTD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8760 CENTER PKWY APT 345
Mailing Address - Street 2:
Mailing Address - City:ELK GROVE
Mailing Address - State:CA
Mailing Address - Zip Code:95758-8448
Mailing Address - Country:US
Mailing Address - Phone:916-878-8647
Mailing Address - Fax:
Practice Address - Street 1:5340 ELVAS AVE STE 300
Practice Address - Street 2:
Practice Address - City:SACRAMENTO
Practice Address - State:CA
Practice Address - Zip Code:95819-2391
Practice Address - Country:US
Practice Address - Phone:916-346-9352
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-07-14
Last Update Date:2025-07-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA26155225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist