Healthcare Provider Details

I. General information

NPI: 1336819994
Provider Name (Legal Business Name): SABRINA J GRIJALVA LCSW
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/15/2021
Last Update Date: 01/07/2026
Certification Date: 01/07/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6500 WILSHIRE BLVD FL 19
LOS ANGELES CA
90048-4920
US

IV. Provider business mailing address

2331 ALHAMBRA BLVD
SACRAMENTO CA
95817-1108
US

V. Phone/Fax

Practice location:
  • Phone: 805-764-9651
  • Fax: 323-866-8800
Mailing address:
  • Phone: 408-854-2147
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code104100000X
TaxonomySocial Worker
License Number107266
License Number StateCA
# 2
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number130109
License Number StateCA
# 3
Primary TaxonomyN
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number
License Number StateNULL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: