Provider Demographics
NPI:1033770060
Name:SARABIA, GIAN MICHAEL
Entity type:Individual
Prefix:
First Name:GIAN
Middle Name:MICHAEL
Last Name:SARABIA
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1427 MIRAMONTE AVE
Mailing Address - Street 2:
Mailing Address - City:LOS ALTOS
Mailing Address - State:CA
Mailing Address - Zip Code:94024-5604
Mailing Address - Country:US
Mailing Address - Phone:650-977-2290
Mailing Address - Fax:
Practice Address - Street 1:1427 MIRAMONTE AVE
Practice Address - Street 2:
Practice Address - City:LOS ALTOS
Practice Address - State:CA
Practice Address - Zip Code:94024-5604
Practice Address - Country:US
Practice Address - Phone:669-977-2290
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-06-20
Last Update Date:2024-10-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
150458106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist