Provider Demographics
NPI:1164868444
Name:MULLIN, SARAH (PH D)
Entity Type:Individual
Prefix:DR
First Name:SARAH
Middle Name:
Last Name:MULLIN
Suffix:
Gender:F
Credentials:PH D
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:18 MOUNTAIN VIEW RD
Mailing Address - Street 2:
Mailing Address - City:FAIRFAX
Mailing Address - State:CA
Mailing Address - Zip Code:94930-1913
Mailing Address - Country:US
Mailing Address - Phone:415-846-5096
Mailing Address - Fax:
Practice Address - Street 1:18 MOUNTAIN VIEW RD
Practice Address - Street 2:
Practice Address - City:FAIRFAX
Practice Address - State:CA
Practice Address - Zip Code:94930-1913
Practice Address - Country:US
Practice Address - Phone:415-846-5096
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-05-14
Last Update Date:2022-06-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAPSY26139103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAPSY26139OtherCLINICAL PSYCHOLOGIST LICENSE NUMBER