Provider Demographics
NPI:1003549957
Name:DAHLGREN-DAWSON, SARAH MARIE
Entity Type:Individual
Prefix:
First Name:SARAH
Middle Name:MARIE
Last Name:DAHLGREN-DAWSON
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3848 CASTRO VALLEY BLVD
Mailing Address - Street 2:
Mailing Address - City:CASTRO VALLEY
Mailing Address - State:CA
Mailing Address - Zip Code:94546-4599
Mailing Address - Country:US
Mailing Address - Phone:510-886-3341
Mailing Address - Fax:510-883-4896
Practice Address - Street 1:3848 CASTRO VALLEY BLVD
Practice Address - Street 2:
Practice Address - City:CASTRO VALLEY
Practice Address - State:CA
Practice Address - Zip Code:94546-4599
Practice Address - Country:US
Practice Address - Phone:510-886-3341
Practice Address - Fax:510-883-4896
Is Sole Proprietor?:Yes
Enumeration Date:2022-07-07
Last Update Date:2022-07-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA113340183700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183700000XPharmacy Service ProvidersPharmacy Technician