Provider Demographics
NPI:1689349193
Name:JIRINZU CARRATALA, SARAH
Entity Type:Individual
Prefix:
First Name:SARAH
Middle Name:
Last Name:JIRINZU CARRATALA
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 1:1100 NW LOOP 410 STE 700
Mailing Address - Street 2:
Mailing Address - City:SAN ANTONIO
Mailing Address - State:TX
Mailing Address - Zip Code:78213-2258
Mailing Address - Country:US
Mailing Address - Phone:210-819-5507
Mailing Address - Fax:214-764-8496
Practice Address - Street 1:1100 NW LOOP 410 STE 700
Practice Address - Street 2:
Practice Address - City:SAN ANTONIO
Practice Address - State:TX
Practice Address - Zip Code:78213-2258
Practice Address - Country:US
Practice Address - Phone:210-819-5507
Practice Address - Fax:214-764-8496
Is Sole Proprietor?:Yes
Enumeration Date:2021-08-16
Last Update Date:2023-10-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX1050277363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health