MEDICARE: SARAH RUSHWORTH

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	103K00000X	Behavior Analyst		CA

General Provider Information

NPI Number	:	1245734466
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	SARAH RUSHWORTH

Provider Business Mailing Address
First Line	:	2300 N POINT ST APT 204
Second Line	:
City	:	SAN FRANCISCO
State	:	CA
Zip	:	94123-1439
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	2300 N POINT ST APT 204
Second Line	:
City	:	SAN FRANCISCO
State	:	CA
Zip	:	94123-1439
Country	:	US
Telephone Number	:	415-250-8304
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	03/21/2018
Last Update Date	:	03/21/2018

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Directions to “ SARAH RUSHWORTH ” Practice Location

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