Provider Demographics
NPI:1063278166
Name:STEIN, SARA ARLYN
Entity type:Individual
Prefix:
First Name:SARA
Middle Name:ARLYN
Last Name:STEIN
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 1:310 CHANNING WAY APT 219
Mailing Address - Street 2:
Mailing Address - City:SAN RAFAEL
Mailing Address - State:CA
Mailing Address - Zip Code:94903-2626
Mailing Address - Country:US
Mailing Address - Phone:530-307-3003
Mailing Address - Fax:
Practice Address - Street 1:310 CHANNING WAY APT 219
Practice Address - Street 2:
Practice Address - City:SAN RAFAEL
Practice Address - State:CA
Practice Address - Zip Code:94903-2626
Practice Address - Country:US
Practice Address - Phone:530-307-3003
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-02-26
Last Update Date:2024-02-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)