Provider Demographics
NPI:1831675073
Name:CHRISTIANSEN, SAHBA (SAHBA)
Entity Type:Individual
Prefix:
First Name:SAHBA
Middle Name:
Last Name:CHRISTIANSEN
Suffix:
Gender:F
Credentials:SAHBA
Other - Prefix:
Other - First Name:SAHBA
Other - Middle Name:
Other - Last Name:CHRISTIANSEN
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:PHARMACIST
Mailing Address - Street 1:105 ORANGE BLOSSOM CIR
Mailing Address - Street 2:
Mailing Address - City:LADERA RANCH
Mailing Address - State:CA
Mailing Address - Zip Code:92694-1253
Mailing Address - Country:US
Mailing Address - Phone:949-394-7740
Mailing Address - Fax:
Practice Address - Street 1:951 AVENIDA PICO
Practice Address - Street 2:
Practice Address - City:SAN CLEMENTE
Practice Address - State:CA
Practice Address - Zip Code:92673-3908
Practice Address - Country:US
Practice Address - Phone:949-498-6679
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-07-11
Last Update Date:2018-07-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA50868183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist