Provider Demographics
NPI:1073677985
Name:STILWELL, SABRINA N (OD)
Entity Type:Individual
Prefix:
First Name:SABRINA
Middle Name:N
Last Name:STILWELL
Suffix:
Gender:F
Credentials:OD
Other - Prefix:
Other - First Name:SABRINA
Other - Middle Name:N
Other - Last Name:CHAN
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:OD
Mailing Address - Street 1:447 22ND AVE
Mailing Address - Street 2:APT 1
Mailing Address - City:SAN FRANCISCO
Mailing Address - State:CA
Mailing Address - Zip Code:94121-3000
Mailing Address - Country:US
Mailing Address - Phone:925-708-5089
Mailing Address - Fax:
Practice Address - Street 1:1033 3RD ST
Practice Address - Street 2:
Practice Address - City:SAN RAFAEL
Practice Address - State:CA
Practice Address - Zip Code:94901-3107
Practice Address - Country:US
Practice Address - Phone:415-482-6826
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-12-22
Last Update Date:2022-01-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA13100T152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist