Healthcare Provider Details

I. General information

NPI: 1336276872
Provider Name (Legal Business Name): MS. MARIE G SABIN
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 02/28/2007
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2100 5TH ST
DAVIS CA
95616-6591
US

IV. Provider business mailing address

2100 5TH ST
DAVIS CA
95616-6591
US

V. Phone/Fax

Practice location:
  • Phone: 530-747-3372
  • Fax: 530-753-0398
Mailing address:
  • Phone: 530-747-3372
  • Fax: 530-753-0398

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101Y00000X
TaxonomyCounselor
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: