Provider Demographics
NPI:1538235411
Name:BEYER, SARAH POLSELLI (PHD)
Entity type:Individual
Prefix:DR
First Name:SARAH
Middle Name:POLSELLI
Last Name:BEYER
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2022 ABBOTT ST
Mailing Address - Street 2:
Mailing Address - City:SAN DIEGO
Mailing Address - State:CA
Mailing Address - Zip Code:92107-2504
Mailing Address - Country:US
Mailing Address - Phone:858-229-8070
Mailing Address - Fax:619-892-7033
Practice Address - Street 1:2423 CAMINO DEL RIO S
Practice Address - Street 2:SUITE 205
Practice Address - City:SAN DIEGO
Practice Address - State:CA
Practice Address - Zip Code:92108-3702
Practice Address - Country:US
Practice Address - Phone:619-961-3800
Practice Address - Fax:619-810-2439
Is Sole Proprietor?:Yes
Enumeration Date:2006-11-24
Last Update Date:2012-11-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA23883103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical