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General NPI Number Information
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NPI Number | 1285254078
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Entity Type | Individual
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Provider Name | SABRINA LAUREN HERBERT
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Gender | Female
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Dates
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Enumeration Date | 04/21/2020
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Last Update Date | 01/19/2022
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Provider Practice Location Address
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Address Line | 380 E ATEN RD
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City | IMPERIAL
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State | CA
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Zip | 92251-9653
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Country | US
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Telephone | 760-355-6510
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Fax |
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Provider Business Mailing Address
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Address Line | 2202 DESERT GARDENS DR
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City | EL CENTRO
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State | CA
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Zip | 92243-9421
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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 | 2255A2300X
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Taxonomy Name | Athletic Trainer
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License Number | BOC2000042244
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License Number State |
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