Provider Demographics
NPI:1194159970
Name:THAKUR, SABRINA SHRITA (MASTER OF SCIENCE)
Entity type:Individual
Prefix:MS
First Name:SABRINA
Middle Name:SHRITA
Last Name:THAKUR
Suffix:
Gender:F
Credentials:MASTER OF SCIENCE
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:572 N ARROWHEAD
Mailing Address - Street 2:
Mailing Address - City:SAN BERNARDINO
Mailing Address - State:CA
Mailing Address - Zip Code:92401
Mailing Address - Country:US
Mailing Address - Phone:909-677-8947
Mailing Address - Fax:909-266-2790
Practice Address - Street 1:572 N ARROWHEAD
Practice Address - Street 2:
Practice Address - City:SAN BERNARDINO
Practice Address - State:CA
Practice Address - Zip Code:92401
Practice Address - Country:US
Practice Address - Phone:909-677-8947
Practice Address - Fax:909-266-2790
Is Sole Proprietor?:No
Enumeration Date:2013-08-28
Last Update Date:2015-03-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAIMF67404106H00000X
CALMFT#85605106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist