Healthcare Provider Details

I. General information

NPI: 1962212100
Provider Name (Legal Business Name): SOPHIA ANNE SANGUINETTI
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 01/09/2025
Last Update Date: 08/12/2025
Certification Date: 08/12/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

901 CASTRO ST
SAN FRANCISCO CA
94114-3209
US

IV. Provider business mailing address

1538 LARKIN ST # 1538
SAN FRANCISCO CA
94109-3789
US

V. Phone/Fax

Practice location:
  • Phone: 415-255-9395
  • Fax:
Mailing address:
  • Phone: 707-256-9828
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number20778
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: