Healthcare Provider Details

I. General information

NPI: 1376766907
Provider Name (Legal Business Name): THERESA H SAPUNAR IMFT
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 04/11/2007
Last Update Date: 03/31/2026
Certification Date: 03/31/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

663 J ST APT B
ARCATA CA
95521-4110
US

IV. Provider business mailing address

663 J ST APT C
ARCATA CA
95521-4110
US

V. Phone/Fax

Practice location:
  • Phone: 404-229-1812
  • Fax:
Mailing address:
  • Phone: 404-229-1812
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code106H00000X
TaxonomyMarriage & Family Therapist
License NumberCA24473
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: