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NPI Code Detail

MEDICARE: SABRINA DANESHVAR PH.D., LCP, BCBA-D

MEDICARE: SABRINA DANESHVAR PH.D., LCP, BCBA-D
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
1103TC0700XClinical PsychologistPSY 28358CA
2103K00000XBehavior Analyst1-04-1563

General Provider Information

NPI Number : 1952673931
Entity Type Code : Individual
Provider Name (Legal Business Name) : SABRINA DANESHVAR PH.D., LCP, BCBA-D
Provider Business Mailing Address
First Line : 4719 VIEWRIDGE AVE STE 100
Second Line :
City : SAN DIEGO
State : CA
Zip : 92123-1685
Country : US
Telephone Number : 866-727-8274
Fax Number :
Provider Business Practice Location Address
First Line : 4719 VIEWRIDGE AVE STE 100
Second Line :
City : SAN DIEGO
State : CA
Zip : 92123-1685
Country : US
Telephone Number : 866-727-8274
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 02/06/2012
Last Update Date : 08/01/2017

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