Provider Demographics
NPI:1689169765
Name:JOSEPHSON, SABRINA S (BEHAVIORAL TECHNICIA)
Entity Type:Individual
Prefix:
First Name:SABRINA
Middle Name:S
Last Name:JOSEPHSON
Suffix:
Gender:F
Credentials:BEHAVIORAL TECHNICIA
Other - Prefix:
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Mailing Address - Street 1:11037 WARNER AVE # 339
Mailing Address - Street 2:
Mailing Address - City:FOUNTAIN VALLEY
Mailing Address - State:CA
Mailing Address - Zip Code:92708-4007
Mailing Address - Country:US
Mailing Address - Phone:714-848-8319
Mailing Address - Fax:714-596-6274
Practice Address - Street 1:4949 SW MACADAM AVE # 30
Practice Address - Street 2:
Practice Address - City:PORTLAND
Practice Address - State:OR
Practice Address - Zip Code:97239-3912
Practice Address - Country:US
Practice Address - Phone:800-273-4292
Practice Address - Fax:888-293-3374
Is Sole Proprietor?:No
Enumeration Date:2018-06-29
Last Update Date:2018-06-29
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
CARBT-17-43341106S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician