Provider Demographics
NPI:1730863085
Name:DRINKWINE, SARAH JEAN (APCC)
Entity type:Individual
Prefix:
First Name:SARAH
Middle Name:JEAN
Last Name:DRINKWINE
Suffix:
Gender:F
Credentials:APCC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2910 COVENTRY CIR
Mailing Address - Street 2:
Mailing Address - City:CORONA
Mailing Address - State:CA
Mailing Address - Zip Code:92879-5866
Mailing Address - Country:US
Mailing Address - Phone:951-858-4654
Mailing Address - Fax:
Practice Address - Street 1:23950 PRADO LN
Practice Address - Street 2:
Practice Address - City:COLTON
Practice Address - State:CA
Practice Address - Zip Code:92324-9734
Practice Address - Country:US
Practice Address - Phone:909-264-3181
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-06-14
Last Update Date:2023-06-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA6869101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health