Provider Demographics
NPI:1376910984
Name:TATLOCK, SARAH C. A (LCSW)
Entity Type:Individual
Prefix:MISS
First Name:SARAH C.
Middle Name:A
Last Name:TATLOCK
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:MISS
Other - First Name:SARAH CATHERINE
Other - Middle Name:APRIL
Other - Last Name:TATLOCK
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:LCSW
Mailing Address - Street 1:3255 WING ST
Mailing Address - Street 2:
Mailing Address - City:SAN DIEGO
Mailing Address - State:CA
Mailing Address - Zip Code:92110-4638
Mailing Address - Country:US
Mailing Address - Phone:619-221-8600
Mailing Address - Fax:
Practice Address - Street 1:3255 WING ST
Practice Address - Street 2:
Practice Address - City:SAN DIEGO
Practice Address - State:CA
Practice Address - Zip Code:92110-4638
Practice Address - Country:US
Practice Address - Phone:619-221-8600
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2015-08-31
Last Update Date:2023-10-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MELC152501041C0700X
CALCSW1108631041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical