Provider Demographics
NPI:1548642150
Name:SARABIA, BRENDA (LCSW)
Entity type:Individual
Prefix:MS
First Name:BRENDA
Middle Name:
Last Name:SARABIA
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:BRENDA
Other - Middle Name:
Other - Last Name:PRESTON
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:3255 CAMINO DEL RIO S
Mailing Address - Street 2:
Mailing Address - City:SAN DIEGO
Mailing Address - State:CA
Mailing Address - Zip Code:92108-3806
Mailing Address - Country:US
Mailing Address - Phone:619-606-3981
Mailing Address - Fax:
Practice Address - Street 1:3255 CAMINO DEL RIO S
Practice Address - Street 2:
Practice Address - City:SAN DIEGO
Practice Address - State:CA
Practice Address - Zip Code:92108-3806
Practice Address - Country:US
Practice Address - Phone:619-606-3981
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2015-06-19
Last Update Date:2024-11-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA73782101YM0800X
CAASW73782101YM0800X
CA874411041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Single Specialty