Provider Demographics
NPI:1619162864
Name:DIHMES, SARAH (PHD BCIA)
Entity Type:Individual
Prefix:
First Name:SARAH
Middle Name:
Last Name:DIHMES
Suffix:
Gender:F
Credentials:PHD BCIA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:17 CAPTAIN'S LANDING
Mailing Address - Street 2:
Mailing Address - City:TIBURON
Mailing Address - State:CA
Mailing Address - Zip Code:94920
Mailing Address - Country:US
Mailing Address - Phone:443-722-1208
Mailing Address - Fax:
Practice Address - Street 1:17 CAPTAIN'S LANDING
Practice Address - Street 2:
Practice Address - City:TIBURON
Practice Address - State:CA
Practice Address - Zip Code:94920
Practice Address - Country:US
Practice Address - Phone:443-722-1208
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-09-11
Last Update Date:2018-11-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA103TH0004X, 103T00000X
390200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist
No103TH0004XBehavioral Health & Social Service ProvidersPsychologistHealth
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program