Provider Demographics
NPI:1184232019
Name:TRABOLD, SARAH ANNE (NP)
Entity Type:Individual
Prefix:
First Name:SARAH
Middle Name:ANNE
Last Name:TRABOLD
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1206 LAKME AVE
Mailing Address - Street 2:
Mailing Address - City:WILMINGTON
Mailing Address - State:CA
Mailing Address - Zip Code:90744-2628
Mailing Address - Country:US
Mailing Address - Phone:562-357-3333
Mailing Address - Fax:
Practice Address - Street 1:3440 LOMITA BLVD STE 240
Practice Address - Street 2:
Practice Address - City:TORRANCE
Practice Address - State:CA
Practice Address - Zip Code:90505-4871
Practice Address - Country:US
Practice Address - Phone:310-539-5060
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-07-16
Last Update Date:2022-01-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA95014948363LW0102X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LW0102XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerWomen's Health