Provider Demographics
NPI:1174219257
Name:MOSS, SABRINA ROCHELLE
Entity type:Individual
Prefix:
First Name:SABRINA
Middle Name:ROCHELLE
Last Name:MOSS
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:SABRINA
Other - Middle Name:ROCHELLE
Other - Last Name:FULCHER
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:9419 HASKELL AVE
Mailing Address - Street 2:
Mailing Address - City:NORTH HILLS
Mailing Address - State:CA
Mailing Address - Zip Code:91343-3118
Mailing Address - Country:US
Mailing Address - Phone:323-314-9144
Mailing Address - Fax:
Practice Address - Street 1:9419 HASKELL AVE
Practice Address - Street 2:
Practice Address - City:NORTH HILLS
Practice Address - State:CA
Practice Address - Zip Code:91343-3118
Practice Address - Country:US
Practice Address - Phone:888-858-1601
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-04-12
Last Update Date:2024-05-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist