Healthcare Provider Details

I. General information

NPI: 1922914589
Provider Name (Legal Business Name): COURTNEY D SAHAGUN
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/21/2026
Last Update Date: 08/21/2026
Certification Date: 08/21/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

321 IOWA ST
FALLBROOK CA
92028-2108
US

IV. Provider business mailing address

321 IOWA ST
FALLBROOK CA
92028-2108
US

V. Phone/Fax

Practice location:
  • Phone: 916-759-5632
  • Fax:
Mailing address:
  • Phone: 916-759-5632
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225X00000X
TaxonomyOccupational Therapist
License Number
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: