Healthcare Provider Details

I. General information

NPI: 1487558623
Provider Name (Legal Business Name): SAKURA THERAPY & WELLNESS, A LICENSED PROFESSIONAL CLINICAL COUNSELOR CORPORATION
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

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

III. Provider practice location address

8025 SILVERCREST WAY
SAN DIEGO CA
92126-4482
US

IV. Provider business mailing address

4653 CARMEL MOUNTAIN RD STE 308 #AA247
SAN DIEGO CA
92130-6650
US

V. Phone/Fax

Practice location:
  • Phone: 619-324-3281
  • Fax:
Mailing address:
  • Phone: 619-324-3281
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number
License Number StateNULL

VIII. Authorized Official

Name: CARMEN CRISTINA PANZARINI
Title or Position: OWNER
Credential: LMHC, LPCC
Phone: 619-324-3281