Provider Demographics
NPI:1205222411
Name:SARABIA, JOSEFINA (LMFT)
Entity Type:Individual
Prefix:
First Name:JOSEFINA
Middle Name:
Last Name:SARABIA
Suffix:
Gender:F
Credentials:LMFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2080 S E ST STE 200
Mailing Address - Street 2:
Mailing Address - City:SAN BERNARDINO
Mailing Address - State:CA
Mailing Address - Zip Code:92408-2746
Mailing Address - Country:US
Mailing Address - Phone:909-388-9191
Mailing Address - Fax:909-388-9195
Practice Address - Street 1:2080 S E ST STE 200
Practice Address - Street 2:
Practice Address - City:SAN BERNARDINO
Practice Address - State:CA
Practice Address - Zip Code:92408-2746
Practice Address - Country:US
Practice Address - Phone:909-388-9191
Practice Address - Fax:909-388-9195
Is Sole Proprietor?:No
Enumeration Date:2015-04-14
Last Update Date:2023-06-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
103K00000X
CAAMFT86886106H00000X
CAIMF86886106H00000X
CAAMFT125733106H00000X
CALMFT139931106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist
No103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA95-2633765OtherMEDI-CAL