Provider Demographics
NPI:1871862250
Name:SABALA, ROSARIO
Entity Type:Individual
Prefix:
First Name:ROSARIO
Middle Name:
Last Name:SABALA
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:57407 29 PALMS HWY
Mailing Address - Street 2:SUITE F
Mailing Address - City:YUCCA VALLEY
Mailing Address - State:CA
Mailing Address - Zip Code:92284-2907
Mailing Address - Country:US
Mailing Address - Phone:760-366-1541
Mailing Address - Fax:760-228-1614
Practice Address - Street 1:57407 29 PALMS HWY
Practice Address - Street 2:SUITE F
Practice Address - City:YUCCA VALLEY
Practice Address - State:CA
Practice Address - Zip Code:92284-2907
Practice Address - Country:US
Practice Address - Phone:760-366-1541
Practice Address - Fax:760-228-1614
Is Sole Proprietor?:No
Enumeration Date:2011-12-14
Last Update Date:2013-09-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist