Provider Demographics
NPI:1003323189
Name:GRUSZKA, SARAH NEWTON (PSYD)
Entity Type:Individual
Prefix:DR
First Name:SARAH
Middle Name:NEWTON
Last Name:GRUSZKA
Suffix:
Gender:F
Credentials:PSYD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:440 STEVENS AVE STE 200
Mailing Address - Street 2:
Mailing Address - City:SOLANA BEACH
Mailing Address - State:CA
Mailing Address - Zip Code:92075-2059
Mailing Address - Country:US
Mailing Address - Phone:443-534-4268
Mailing Address - Fax:
Practice Address - Street 1:440 STEVENS AVE STE 200
Practice Address - Street 2:
Practice Address - City:SOLANA BEACH
Practice Address - State:CA
Practice Address - Zip Code:92075-2059
Practice Address - Country:US
Practice Address - Phone:443-534-4268
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-01-10
Last Update Date:2022-04-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD05632103T00000X
CA28978103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA28978OtherPSYCHOLOGY LICENSE
MD05632OtherPSYCHOLOGY LICENSE