MEDICARE: MRS. DIANA CALDERON SARABIA IMF 57398

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	106H00000X	Marriage & Family Therapist	IMF59693	CA

General Provider Information

NPI Number	:	1134454101
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MRS. DIANA CALDERON SARABIA IMF 57398

Provider Business Mailing Address
First Line	:	4811 CHIPPENDALE DR
Second Line	:	SUITE 601
City	:	SACRAMENTO
State	:	CA
Zip	:	95841-2555
Country	:	US
Telephone Number	:	916-267-5832
Fax Number	:

Provider Business Practice Location Address
First Line	:	4811 CHIPPENDALE DR
Second Line	:	SUITE 601
City	:	SACRAMENTO
State	:	CA
Zip	:	95841-2555
Country	:	US
Telephone Number	:	916-267-5832
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	10/08/2009
Last Update Date	:	12/19/2012

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