Provider Demographics
NPI:1649323353
Name:WILLIAMSON, SARA A (ATC)
Entity type:Individual
Prefix:MRS
First Name:SARA
Middle Name:A
Last Name:WILLIAMSON
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 1:12710 LA TORTOLA
Mailing Address - Street 2:
Mailing Address - City:SAN DIEGO
Mailing Address - State:CA
Mailing Address - Zip Code:92129-3071
Mailing Address - Country:US
Mailing Address - Phone:858-538-5370
Mailing Address - Fax:
Practice Address - Street 1:12710 LA TORTOLA
Practice Address - Street 2:
Practice Address - City:SAN DIEGO
Practice Address - State:CA
Practice Address - Zip Code:92129-3071
Practice Address - Country:US
Practice Address - Phone:858-538-5370
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-18
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2255A2300XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersSpecialist/TechnologistAthletic Trainer