Provider Demographics
NPI:1972122638
Name:CERVANTES, SABINA NATALIE (AMFT)
Entity Type:Individual
Prefix:
First Name:SABINA
Middle Name:NATALIE
Last Name:CERVANTES
Suffix:
Gender:F
Credentials:AMFT
Other - Prefix:
Other - First Name:SABINA
Other - Middle Name:NATALIE
Other - Last Name:HERNANDEZ
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:AMFT
Mailing Address - Street 1:823 GATEWAY CENTER WAY
Mailing Address - Street 2:
Mailing Address - City:SAN DIEGO
Mailing Address - State:CA
Mailing Address - Zip Code:92102-4541
Mailing Address - Country:US
Mailing Address - Phone:619-515-2300
Mailing Address - Fax:
Practice Address - Street 1:8530 LA MESA BLVD STE 306
Practice Address - Street 2:
Practice Address - City:LA MESA
Practice Address - State:CA
Practice Address - Zip Code:91942-0967
Practice Address - Country:US
Practice Address - Phone:619-876-4426
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-04-13
Last Update Date:2023-07-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA127241101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health