Healthcare Provider Details

I. General information

NPI: 1609730233
Provider Name (Legal Business Name): SARAH COZIK
Entity Type: Individual
Gender:
Sole Proprietor: N

II. Dates (important events)

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

III. Provider practice location address

3540 AERO CT
SAN DIEGO CA
92123-1711
US

IV. Provider business mailing address

6731 CLARA LEE AVE
SAN DIEGO CA
92120-1002
US

V. Phone/Fax

Practice location:
  • Phone: 714-615-7711
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code171400000X
TaxonomyHealth & Wellness Coach
License Number2F9A0BBCA7
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: