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NPI 1780393637

NPI 1780393637 : JILL SAGNER : SOLVANG, CA

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General NPI Number Information
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    NPI Number           |    1780393637
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    Entity Type          |    Individual 
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    Provider Name        |    JILL SAGNER
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    Gender               |    Female 
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Dates
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    Enumeration Date     |    11/18/2022
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    Last Update Date     |    12/11/2025
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Provider Practice Location Address
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    Address Line         |    650 ALAMO PINTADO RD STE 103 
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    City                 |    SOLVANG
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    State                |    CA
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    Zip                  |    93463-2266
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    Country              |    US
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    Telephone            |    805-680-7827
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    Fax                  |    
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Provider Business Mailing Address
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    Address Line         |    PO BOX 864 
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    City                 |    SOLVANG
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    State                |    CA
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    Zip                  |    93464-0864
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    Country              |    US
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    Telephone            |    650-924-1085
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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        |    106H00000X
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    Taxonomy Name        |    Marriage & Family Therapist
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    License Number       |    144758
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    License Number State |    CA
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