1043229396 NPI number — MRS. SARA ASHWORTH GALBRAITH M.S.

Table of content: MRS. SARA ASHWORTH GALBRAITH M.S. (NPI 1043229396)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1043229396 NPI number — MRS. SARA ASHWORTH GALBRAITH M.S.

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
GALBRAITH
Provider First Name:
SARA
Provider Middle Name:
ASHWORTH
Provider Name Prefix Text:
MRS.
Provider Name Suffix Text:
Provider Credential Text:
M.S.
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1043229396
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
07/08/2007
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
2620 J ST
Provider Second Line Business Mailing Address:
2ND FLOOR
Provider Business Mailing Address City Name:
SACRAMENTO
Provider Business Mailing Address State Name:
CA
Provider Business Mailing Address Postal Code:
95816-4313
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
916-498-1322
Provider Business Mailing Address Fax Number:
530-792-8323

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
2620 J ST
Provider Second Line Business Practice Location Address:
2ND FLOOR
Provider Business Practice Location Address City Name:
SACRAMENTO
Provider Business Practice Location Address State Name:
CA
Provider Business Practice Location Address Postal Code:
95816-4313
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
916-498-1322
Provider Business Practice Location Address Fax Number:
530-792-8323
Provider Enumeration Date:
08/05/2006

Additional Information

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 106H00000X , with the licence number:  MFC 31125 , registered in the state of CA ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)





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