Provider Demographics
NPI:1033915095
Name:CAMPOS, SARAH LEAH
Entity type:Individual
Prefix:
First Name:SARAH
Middle Name:LEAH
Last Name:CAMPOS
Suffix:
Gender:
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1324 S DRIFTWOOD DR
Mailing Address - Street 2:
Mailing Address - City:PALM SPRINGS
Mailing Address - State:CA
Mailing Address - Zip Code:92264-8524
Mailing Address - Country:US
Mailing Address - Phone:310-756-9663
Mailing Address - Fax:
Practice Address - Street 1:1324 S DRIFTWOOD DR
Practice Address - Street 2:
Practice Address - City:PALM SPRINGS
Practice Address - State:CA
Practice Address - Zip Code:92264-8524
Practice Address - Country:US
Practice Address - Phone:310-756-9663
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-02-20
Last Update Date:2025-02-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CMI103004171R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes171R00000XOther Service ProvidersInterpreterGroup - Single Specialty