Provider Demographics
NPI:1942690045
Name:CUSENZA, SARAH
Entity Type:Individual
Prefix:
First Name:SARAH
Middle Name:
Last Name:CUSENZA
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 1:91 ROBINSON DR
Mailing Address - Street 2:
Mailing Address - City:SAN FRANCISCO
Mailing Address - State:CA
Mailing Address - Zip Code:94112-4571
Mailing Address - Country:US
Mailing Address - Phone:650-291-4295
Mailing Address - Fax:
Practice Address - Street 1:91 ROBINSON DR
Practice Address - Street 2:
Practice Address - City:SAN FRANCISCO
Practice Address - State:CA
Practice Address - Zip Code:94112-4571
Practice Address - Country:US
Practice Address - Phone:650-291-4295
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2015-01-27
Last Update Date:2015-01-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health