Provider Demographics
NPI:1710677950
Name:CARBONI, SABRINA RAE (PSYD PPS LEP)
Entity Type:Individual
Prefix:DR
First Name:SABRINA
Middle Name:RAE
Last Name:CARBONI
Suffix:
Gender:F
Credentials:PSYD PPS LEP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:31 SANDPIPER AVE
Mailing Address - Street 2:
Mailing Address - City:SAN CLEMENTE
Mailing Address - State:CA
Mailing Address - Zip Code:92672-2616
Mailing Address - Country:US
Mailing Address - Phone:951-313-0422
Mailing Address - Fax:
Practice Address - Street 1:23046 AVENIDA DE LA CARLOTA STE 619
Practice Address - Street 2:
Practice Address - City:LAGUNA HILLS
Practice Address - State:CA
Practice Address - Zip Code:92653-1548
Practice Address - Country:US
Practice Address - Phone:949-542-5499
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-05-10
Last Update Date:2023-05-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA4340103TS0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103TS0200XBehavioral Health & Social Service ProvidersPsychologistSchoolGroup - Single Specialty