Healthcare Provider Details

I. General information

NPI: 1013444041
Provider Name (Legal Business Name): SARAH MARIE INKELIS
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/22/2017
Last Update Date: 10/02/2026
Certification Date: 10/02/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1651 4TH ST STE 212
SAN FRANCISCO CA
94158-2324
US

IV. Provider business mailing address

3754 1ST AVE APT C
SAN DIEGO CA
92103-4089
US

V. Phone/Fax

Practice location:
  • Phone: 415-353-2057
  • Fax:
Mailing address:
  • Phone: 323-533-2321
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103G00000X
TaxonomyClinical Neuropsychologist
License NumberPSY34447
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: