Provider Demographics
NPI:1659249555
Name:SCHULTZ, SABRINA SARA (SUDRC)
Entity type:Individual
Prefix:
First Name:SABRINA
Middle Name:SARA
Last Name:SCHULTZ
Suffix:
Gender:F
Credentials:SUDRC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:541 ALAMEDA DEL PRADO APT 304
Mailing Address - Street 2:
Mailing Address - City:NOVATO
Mailing Address - State:CA
Mailing Address - Zip Code:94949-6081
Mailing Address - Country:US
Mailing Address - Phone:415-446-6655
Mailing Address - Fax:
Practice Address - Street 1:541 ALAMEDA DEL PRADO APT 304
Practice Address - Street 2:
Practice Address - City:NOVATO
Practice Address - State:CA
Practice Address - Zip Code:94949-6081
Practice Address - Country:US
Practice Address - Phone:415-446-6655
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-10-23
Last Update Date:2025-10-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA231134101YA0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)