Provider Demographics
NPI:1376223529
Name:DIGIORGIO-HAAG, SASHA
Entity Type:Individual
Prefix:
First Name:SASHA
Middle Name:
Last Name:DIGIORGIO-HAAG
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:88 MOUNT RAINIER DR
Mailing Address - Street 2:
Mailing Address - City:SAN RAFAEL
Mailing Address - State:CA
Mailing Address - Zip Code:94903-1045
Mailing Address - Country:US
Mailing Address - Phone:415-312-8326
Mailing Address - Fax:
Practice Address - Street 1:201 ALAMEDA DEL PRADO STE 103
Practice Address - Street 2:
Practice Address - City:NOVATO
Practice Address - State:CA
Practice Address - Zip Code:94949-6698
Practice Address - Country:US
Practice Address - Phone:415-457-6964
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-07-21
Last Update Date:2023-08-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor