Provider Demographics
NPI:1538694476
Name:SAKWALL, ANIESA
Entity Type:Individual
Prefix:
First Name:ANIESA
Middle Name:
Last Name:SAKWALL
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6727 TORENIA TRL
Mailing Address - Street 2:APT. 256
Mailing Address - City:SAN DIEGO
Mailing Address - State:CA
Mailing Address - Zip Code:92130-7013
Mailing Address - Country:US
Mailing Address - Phone:858-397-3754
Mailing Address - Fax:
Practice Address - Street 1:1600 N CUYAMACA ST
Practice Address - Street 2:
Practice Address - City:EL CAJON
Practice Address - State:CA
Practice Address - Zip Code:92020-1109
Practice Address - Country:US
Practice Address - Phone:619-956-0615
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-04-28
Last Update Date:2017-04-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225C00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersRehabilitation Counselor