Provider Demographics
NPI:1750815791
Name:HAYDOCK, SARAH MARIE (MSW, PPSC)
Entity Type:Individual
Prefix:MS
First Name:SARAH
Middle Name:MARIE
Last Name:HAYDOCK
Suffix:
Gender:F
Credentials:MSW, PPSC
Other - Prefix:MS
Other - First Name:SARAH
Other - Middle Name:MARIE
Other - Last Name:HAYDOCK
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:MSW, PPSC
Mailing Address - Street 1:4309 3RD AVE
Mailing Address - Street 2:
Mailing Address - City:SAN DIEGO
Mailing Address - State:CA
Mailing Address - Zip Code:92103-1407
Mailing Address - Country:US
Mailing Address - Phone:619-876-4502
Mailing Address - Fax:
Practice Address - Street 1:4309 3RD AVE
Practice Address - Street 2:
Practice Address - City:SAN DIEGO
Practice Address - State:CA
Practice Address - Zip Code:92103-1407
Practice Address - Country:US
Practice Address - Phone:619-876-4502
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-04-17
Last Update Date:2019-05-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program