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General NPI Number Information
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NPI Number | 1447661368
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Entity Type | Individual
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Provider Name | SABRINA MARIE PETROV LAC
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Gender | Female
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Dates
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Enumeration Date | 05/13/2014
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Last Update Date | 05/30/2024
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Provider Practice Location Address
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Address Line | 419 MAIN ST STE 308
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City | PLACERVILLE
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State | CA
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Zip | 95667-5640
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Country | US
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Telephone | 530-919-6558
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Fax | 530-296-4789
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Provider Business Mailing Address
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Address Line | 3364 BIG CUT RD
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City | PLACERVILLE
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State | CA
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Zip | 95667-6619
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Country | US
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Telephone | 530-919-6558
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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 | 171100000X
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Taxonomy Name | Acupuncturist
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License Number | 15687
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License Number State | CA
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