Healthcare Provider Details

I. General information

NPI: 1679256283
Provider Name (Legal Business Name): SABA KBROM
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/09/2023
Last Update Date: 07/24/2025
Certification Date: 07/24/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3800 WATT AVE STE 110
SACRAMENTO CA
95821-2622
US

IV. Provider business mailing address

3800 WATT AVE STE 110
SACRAMENTO CA
95821-2622
US

V. Phone/Fax

Practice location:
  • Phone: 916-344-0249
  • Fax:
Mailing address:
  • Phone: 916-344-0249
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License NumberAPCC19124
License Number StateCA
# 2
Primary TaxonomyN
Taxonomy Code171M00000X
TaxonomyCase Manager/Care Coordinator
License Number
License Number StateNULL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: