Healthcare Provider Details

I. General information

NPI: 1174896930
Provider Name (Legal Business Name): MRS. SARAH MONU MOLLET-FOLTA
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 02/09/2012
Last Update Date: 03/31/2025
Certification Date: 03/31/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1660 HOTEL CIR N STE 314
SAN DIEGO CA
92108-2803
US

IV. Provider business mailing address

1660 HOTEL CIR N STE 314
SAN DIEGO CA
92108-2803
US

V. Phone/Fax

Practice location:
  • Phone: 619-961-2120
  • Fax: 619-961-2138
Mailing address:
  • Phone: 619-961-2120
  • Fax: 619-961-2138

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code101Y00000X
TaxonomyCounselor
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number4566
License Number StateCA
# 4
Primary TaxonomyN
Taxonomy Code171M00000X
TaxonomyCase Manager/Care Coordinator
License Number
License Number State
# 5
Primary TaxonomyY
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License Number15258
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: