Healthcare Provider Details

I. General information

NPI: 1780393637
Provider Name (Legal Business Name): JILL SAGNER
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 11/18/2022
Last Update Date: 12/11/2025
Certification Date: 12/11/2025
Deactivation Date: 04/20/2025
Reactivation Date: 12/09/2025

III. Provider practice location address

650 ALAMO PINTADO RD STE 103
SOLVANG CA
93463-2266
US

IV. Provider business mailing address

PO BOX 864
SOLVANG CA
93464-0864
US

V. Phone/Fax

Practice location:
  • Phone: 805-680-7827
  • Fax:
Mailing address:
  • Phone: 650-924-1085
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code106H00000X
TaxonomyMarriage & Family Therapist
License Number144758
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: