Healthcare Provider Details

I. General information

NPI: 1710861380
Provider Name (Legal Business Name): SARAH SCHMIDTLER
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/05/2025
Last Update Date: 02/24/2026
Certification Date: 02/24/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

9400 RUFFIN CT
SAN DIEGO CA
92123-5300
US

IV. Provider business mailing address

4406 PARK BLVD, SAN DIEGO, CA 92116
SAN DIEGO CA
92123-5300
US

V. Phone/Fax

Practice location:
  • Phone: 858-514-4600
  • Fax:
Mailing address:
  • Phone: 619-928-9549
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License Number21661
License Number StateCA
# 2
Primary TaxonomyY
Taxonomy Code106H00000X
TaxonomyMarriage & Family Therapist
License Number157488
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: