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NPI Code Detail

MEDICARE: SARAH MARIE PAULSEN

MEDICARE: SARAH MARIE PAULSEN
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
1101Y00000XCounselorCC00172MN
2106H00000XMarriage & Family Therapist2787MN
3106H00000XMarriage & Family TherapistIMF 94647CA

General Provider Information

NPI Number : 1174832901
Entity Type Code : Individual
Provider Name (Legal Business Name) : SARAH MARIE PAULSEN
Provider Business Mailing Address
First Line : 4930 NAPLES ST
Second Line :
City : SAN DIEGO
State : CA
Zip : 92110-3820
Country : US
Telephone Number : 619-276-1176
Fax Number : 619-839-3741
Provider Business Practice Location Address
First Line : 4930 NAPLES ST
Second Line :
City : SAN DIEGO
State : CA
Zip : 92110-3820
Country : US
Telephone Number : 619-276-1176
Fax Number : 619-839-3741
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 09/28/2010
Last Update Date : 02/16/2017

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Directions to “ SARAH MARIE PAULSEN ” Practice Location

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