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NPI 1629997614

NPI 1629997614 : ANCHOR CLINICAL & MENTAL HEALTH SERVIES : SAN CLEMENTE, CA

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General NPI Number Information
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    NPI Number           |    1629997614
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    Entity Type          |    Organization 
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    Legal Business Name  |    ANCHOR CLINICAL & MENTAL HEALTH SERVIES 
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Dates
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    Enumeration Date     |    07/13/2026
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    Last Update Date     |    07/13/2026
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Provider Practice Location Address
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    Address Line         |    120 CALLE AMISTAD UNIT 2102 
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    City                 |    SAN CLEMENTE
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    State                |    CA
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    Zip                  |    92673-6918
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    Country              |    US
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    Telephone            |    602-879-2136
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    Fax                  |    
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Provider Business Mailing Address
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    Address Line         |    4058 E ASPEN WAY 
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    City                 |    GILBERT
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    State                |    AZ
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    Zip                  |    85234-7506
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    Country              |    US
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    Telephone            |    602-879-2136
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    Fax                  |    
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Authorized Official
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    Title or Position    |    OWNER
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    Name                 |     SABRINA RAE CARBONI 
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    Credential           |    
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    Telephone            |    602-879-2136
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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       |    
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    License Number State |    
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