Provider Demographics
NPI:1508171349
Name:GILMAN, SARA G (MFT)
Entity Type:Individual
Prefix:MS
First Name:SARA
Middle Name:G
Last Name:GILMAN
Suffix:
Gender:F
Credentials:MFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:374 N COAST HIGHWAY 101 STE F11
Mailing Address - Street 2:
Mailing Address - City:ENCINITAS
Mailing Address - State:CA
Mailing Address - Zip Code:92024-2542
Mailing Address - Country:US
Mailing Address - Phone:760-942-8663
Mailing Address - Fax:760-942-8663
Practice Address - Street 1:374 N COAST HIGHWAY 101 STE F11
Practice Address - Street 2:
Practice Address - City:ENCINITAS
Practice Address - State:CA
Practice Address - Zip Code:92024-2542
Practice Address - Country:US
Practice Address - Phone:760-942-8663
Practice Address - Fax:760-942-8663
Is Sole Proprietor?:Yes
Enumeration Date:2010-08-17
Last Update Date:2010-08-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAMH21586106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist