Healthcare Provider Details

I. General information

NPI: 1790608586
Provider Name (Legal Business Name): SABRINA GOPAR-CORRO
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/30/2026
Last Update Date: 07/30/2026
Certification Date: 07/30/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

316 36TH AVE
SAN MATEO CA
94403-4204
US

IV. Provider business mailing address

316 36TH AVE
SAN MATEO CA
94403-4204
US

V. Phone/Fax

Practice location:
  • Phone: 650-312-7555
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103TS0200X
TaxonomySchool Psychologist
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: