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NPI Code Detail

MEDICARE: SARAH SCHUBMEHL

MEDICARE: SARAH SCHUBMEHL
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
1390200000XStudent in an Organized Health Care Education/Training Program
2103TC0700XClinical PsychologistPSY.0004956CO

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1PSY.0004956OTHERCOLICENSE

General Provider Information

NPI Number : 1538594171
Entity Type Code : Individual
Provider Name (Legal Business Name) : SARAH SCHUBMEHL
Provider Business Mailing Address
First Line : 2909 4TH ST
Second Line :
City : BOULDER
State : CO
Zip : 80304-3044
Country : US
Telephone Number : 805-448-1847
Fax Number :
Provider Business Practice Location Address
First Line : 12975 SHERIDAN BLVD
Second Line :
City : BROOMFIELD
State : CO
Zip : 80020-1477
Country : US
Telephone Number : 888-365-6271
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 09/12/2013
Last Update Date : 08/30/2019

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