Provider Demographics
NPI:1730305822
Name:ERLINE, SARAH DIANE (MACCC-SLP)
Entity Type:Individual
Prefix:MRS
First Name:SARAH
Middle Name:DIANE
Last Name:ERLINE
Suffix:
Gender:F
Credentials:MACCC-SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9975 CONNELL RD
Mailing Address - Street 2:
Mailing Address - City:SAN DIEGO
Mailing Address - State:CA
Mailing Address - Zip Code:92131-1427
Mailing Address - Country:US
Mailing Address - Phone:858-621-3316
Mailing Address - Fax:
Practice Address - Street 1:9975 CONNELL RD
Practice Address - Street 2:
Practice Address - City:SAN DIEGO
Practice Address - State:CA
Practice Address - Zip Code:92131-1427
Practice Address - Country:US
Practice Address - Phone:858-621-3316
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-04-17
Last Update Date:2020-04-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GASLP006349235Z00000X
CA20240235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist