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General NPI Number Information
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NPI Number | 1184589178
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Entity Type | Individual
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Provider Name | SAGE COLER PSYD
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Gender | Female
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Dates
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Enumeration Date | 12/22/2025
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Last Update Date | 12/22/2025
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Provider Practice Location Address
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Address Line | 8808 BALBOA AVE
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City | SAN DIEGO
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State | CA
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Zip | 92123-1592
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Country | US
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Telephone | 619-645-0139
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Fax |
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Provider Business Mailing Address
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Address Line | 2111 MANCHESTER AVE APT C
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City | CARDIFF
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State | CA
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Zip | 92007-1826
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 103TC0700X
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Taxonomy Name | Clinical Psychologist
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License Number | PY61614747
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License Number State | WA
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Taxonomy #2
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Taxonomy Code | 103TC0700X
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Taxonomy Name | Clinical Psychologist
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License Number | PSY36147
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License Number State | CA
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