Healthcare Provider Details

I. General information

NPI: 1356369425
Provider Name (Legal Business Name): SARAH LYNN GIOKARIS PSYD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/17/2006
Last Update Date: 07/01/2009
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6160 MISSION GORGE RD STE 200
SAN DIEGO CA
92120-3410
US

IV. Provider business mailing address

6160 MISSION GORGE RD STE 200
SAN DIEGO CA
92120-3410
US

V. Phone/Fax

Practice location:
  • Phone: 562-412-4191
  • Fax:
Mailing address:
  • Phone: 562-412-4191
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103TC2200X
TaxonomyClinical Child & Adolescent Psychologist
License NumberPSY 21037
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: