Healthcare Provider Details

I. General information

NPI: 1265286710
Provider Name (Legal Business Name): SARA AUCKLAND PHD, CLC
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

Provider Other Name: DR. SARA ABADI

II. Dates (important events)

Enumeration Date: 04/12/2024
Last Update Date: 07/05/2024
Certification Date: 07/05/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

PENISULA PEDIATRIC MEDICAL GROUO 103 GILBERT AVE
MENLO PARK CA
94025
US

IV. Provider business mailing address

3802 CENTURY DR
CAMPBELL CA
95008-3835
US

V. Phone/Fax

Practice location:
  • Phone: 650-497-0660
  • Fax:
Mailing address:
  • Phone: 408-708-6725
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code174N00000X
TaxonomyLactation Consultant (Non-RN)
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: