Provider Demographics
NPI:1790837524
Name:BOESEN, SARAH RACHEL (CCRC)
Entity Type:Individual
Prefix:
First Name:SARAH
Middle Name:RACHEL
Last Name:BOESEN
Suffix:
Gender:F
Credentials:CCRC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:3078 EL CAJON BLVD
Mailing Address - Street 2:FIRST FLOOR
Mailing Address - City:SAN DIEGO
Mailing Address - State:CA
Mailing Address - Zip Code:92104-1322
Mailing Address - Country:US
Mailing Address - Phone:619-521-1743
Mailing Address - Fax:619-521-1896
Practice Address - Street 1:3078 EL CAJON BLVD
Practice Address - Street 2:FIRST FLOOR
Practice Address - City:SAN DIEGO
Practice Address - State:CA
Practice Address - Zip Code:92104-1322
Practice Address - Country:US
Practice Address - Phone:619-521-1743
Practice Address - Fax:619-521-1896
Is Sole Proprietor?:No
Enumeration Date:2007-01-18
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
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Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health