MEDICARE: DR. SARAH LYNN GIOKARIS PSYD

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	103TC2200X	Clinical Child & Adolescent Psychologist	PSY 21037	CA

General Provider Information

NPI Number	:	1356369425
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. SARAH LYNN GIOKARIS PSYD

Provider Business Mailing Address
First Line	:	6160 MISSION GORGE RD
Second Line	:	STE 200
City	:	SAN DIEGO
State	:	CA
Zip	:	92120-3410
Country	:	US
Telephone Number	:	562-412-4191
Fax Number	:

Provider Business Practice Location Address
First Line	:	6160 MISSION GORGE RD
Second Line	:	STE 200
City	:	SAN DIEGO
State	:	CA
Zip	:	92120-3410
Country	:	US
Telephone Number	:	562-412-4191
Fax Number	:

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

Provider Enumeration Date	:	07/17/2006
Last Update Date	:	07/01/2009

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