MEDICARE: DR. SARAH POLSELLI PH.D.

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	103TC0700X	Clinical Psychologist	23883	CA

General Provider Information

NPI Number	:	1538235411
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. SARAH POLSELLI PH.D.

Provider Business Mailing Address
First Line	:	2 MACARTHUR PL STE 900
Second Line	:
City	:	SANTA ANA
State	:	CA
Zip	:	92707-7730
Country	:	US
Telephone Number	:	916-464-4311
Fax Number	:

Provider Business Practice Location Address
First Line	:	2423 CAMINO DEL RIO S
Second Line	:	SUITE 205
City	:	SAN DIEGO
State	:	CA
Zip	:	92108-3702
Country	:	US
Telephone Number	:	619-961-3800
Fax Number	:	619-810-2439

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

Provider Enumeration Date	:	11/24/2006
Last Update Date	:	03/09/2026

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