Provider Demographics
NPI:1265207377
Name:TIEHEN, SARAH ANNE
Entity type:Individual
Prefix:
First Name:SARAH
Middle Name:ANNE
Last Name:TIEHEN
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 1:7412 SEABLUFF DR UNIT 107
Mailing Address - Street 2:
Mailing Address - City:HUNTINGTON BEACH
Mailing Address - State:CA
Mailing Address - Zip Code:92648-6432
Mailing Address - Country:US
Mailing Address - Phone:206-900-2689
Mailing Address - Fax:
Practice Address - Street 1:7412 SEABLUFF DR UNIT 107
Practice Address - Street 2:
Practice Address - City:HUNTINGTON BEACH
Practice Address - State:CA
Practice Address - Zip Code:92648-6432
Practice Address - Country:US
Practice Address - Phone:206-900-2689
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-11-17
Last Update Date:2023-11-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA8787225700000X, 173C00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes173C00000XOther Service ProvidersReflexologist
No225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist