Healthcare Provider Details

I. General information

NPI: 1497446918
Provider Name (Legal Business Name): SARAH TABSH
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/16/2023
Last Update Date: 05/23/2023
Certification Date: 05/23/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

17140 BERNARDO CENTER DR
SAN DIEGO CA
92128-2093
US

IV. Provider business mailing address

17140 BERNARDO CENTER DR
SAN DIEGO CA
92128-2093
US

V. Phone/Fax

Practice location:
  • Phone: 858-282-5180
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code106H00000X
TaxonomyMarriage & Family Therapist
License Number129369
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: