Healthcare Provider Details

I. General information

NPI: 1336670629
Provider Name (Legal Business Name): SARA TIMTIM MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/27/2017
Last Update Date: 02/10/2026
Certification Date: 02/10/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

110 GOUGH ST STE 402
SAN FRANCISCO CA
94102-5971
US

IV. Provider business mailing address

110 GOUGH ST STE 402
SAN FRANCISCO CA
94102-5971
US

V. Phone/Fax

Practice location:
  • Phone: 619-701-6204
  • Fax: 415-449-8850
Mailing address:
  • Phone: 619-701-6204
  • Fax: 415-449-8850

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2084P0800X
TaxonomyPsychiatry Physician
License NumberA162218
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: