Provider Demographics
NPI:1801216098
Name:SAWYER, TERRENCE (MASTERS OF SCIENCE)
Entity Type:Individual
Prefix:MR
First Name:TERRENCE
Middle Name:
Last Name:SAWYER
Suffix:
Gender:M
Credentials:MASTERS OF SCIENCE
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1081 CAMINO DEL RIO S STE 129
Mailing Address - Street 2:
Mailing Address - City:SAN DIEGO
Mailing Address - State:CA
Mailing Address - Zip Code:92108-3544
Mailing Address - Country:US
Mailing Address - Phone:619-255-4383
Mailing Address - Fax:619-296-1846
Practice Address - Street 1:726 F ST FL 2
Practice Address - Street 2:
Practice Address - City:SAN DIEGO
Practice Address - State:CA
Practice Address - Zip Code:92101
Practice Address - Country:US
Practice Address - Phone:619-239-9691
Practice Address - Fax:619-239-0909
Is Sole Proprietor?:Yes
Enumeration Date:2014-04-26
Last Update Date:2018-06-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
101YA0400X
CALCI04430915101YA0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)