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General NPI Number Information
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NPI Number | 1619482775
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Entity Type | Individual
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Provider Name | SARA BETH TAFEEN PSY.D.
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Gender | Female
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Dates
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Enumeration Date | 12/11/2017
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Last Update Date | 01/17/2020
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Provider Practice Location Address
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Address Line | 9888 CARROLL CENTRE RD STE 216
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City | SAN DIEGO
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State | CA
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Zip | 92126-4515
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Country | US
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Telephone | 858-413-7557
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Fax |
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Provider Business Mailing Address
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Address Line | 3424 VILLA TER
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City | SAN DIEGO
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State | CA
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Zip | 92104-3424
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Country | US
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Telephone | 336-327-5548
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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 | 31485
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License Number State | CA
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