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General NPI Number Information
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NPI Number | 1407679335
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Entity Type | Individual
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Provider Name | SARAF SHMUTZ APCC 16213
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Gender | Male
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Dates
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Enumeration Date | 11/07/2024
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Last Update Date | 11/07/2024
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Provider Practice Location Address
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Address Line | 2271 ALPINE BLVD STE A
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City | ALPINE
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State | CA
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Zip | 91901-1101
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Country | US
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Telephone | 888-688-0248
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Fax |
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Provider Business Mailing Address
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Address Line | 2304 ALTISMA WAY UNIT 207
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City | CARLSBAD
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State | CA
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Zip | 92009-6381
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Country | US
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Telephone | 909-317-7655
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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 | 101YM0800X
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Taxonomy Name | Mental Health Counselor
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License Number | APCC16213
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License Number State | CA
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