Healthcare Provider Details

I. General information

NPI: 1285579185
Provider Name (Legal Business Name): SARRAH ALI
Entity Type: Individual
Gender:
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/20/2026
Last Update Date: 04/20/2026
Certification Date: 04/20/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4510 EXECUTIVE DR STE 315
SAN DIEGO CA
92121-3029
US

IV. Provider business mailing address

4510 EXECUTIVE DR STE 315
SAN DIEGO CA
92121-3029
US

V. Phone/Fax

Practice location:
  • Phone: 858-534-8019
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103T00000X
TaxonomyPsychologist
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: