Provider Demographics
NPI:1760408942
Name:GRABOW, SANDRA JEANNE (MSW)
Entity Type:Individual
Prefix:
First Name:SANDRA
Middle Name:JEANNE
Last Name:GRABOW
Suffix:
Gender:F
Credentials:MSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:105 E ST
Mailing Address - Street 2:SUITE 2I
Mailing Address - City:DAVIS
Mailing Address - State:CA
Mailing Address - Zip Code:95616-4697
Mailing Address - Country:US
Mailing Address - Phone:530-756-6541
Mailing Address - Fax:530-758-1834
Practice Address - Street 1:105 E ST
Practice Address - Street 2:SUITE 2I
Practice Address - City:DAVIS
Practice Address - State:CA
Practice Address - Zip Code:95616-4697
Practice Address - Country:US
Practice Address - Phone:530-756-6541
Practice Address - Fax:530-758-1834
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-14
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CALCS111281041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical