Provider Demographics
NPI:1710286166
Name:GLOZER, SARA SUJATA
Entity Type:Individual
Prefix:
First Name:SARA
Middle Name:SUJATA
Last Name:GLOZER
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 1:214 HAIGHT ST
Mailing Address - Street 2:
Mailing Address - City:SAN FRANCISCO
Mailing Address - State:CA
Mailing Address - Zip Code:94102-6127
Mailing Address - Country:US
Mailing Address - Phone:415-503-2331
Mailing Address - Fax:415-776-1066
Practice Address - Street 1:214 HAIGHT ST
Practice Address - Street 2:
Practice Address - City:SAN FRANCISCO
Practice Address - State:CA
Practice Address - Zip Code:94102-6127
Practice Address - Country:US
Practice Address - Phone:415-503-2331
Practice Address - Fax:415-776-1066
Is Sole Proprietor?:No
Enumeration Date:2011-03-24
Last Update Date:2024-02-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
101Y00000X
CA66622106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist
No101Y00000XBehavioral Health & Social Service ProvidersCounselor