Provider Demographics
NPI:1285444877
Name:HEAD, SARAH DORNIC (L AC)
Entity type:Individual
Prefix:MRS
First Name:SARAH
Middle Name:DORNIC
Last Name:HEAD
Suffix:
Gender:F
Credentials:L AC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:159 MONTE VISTA AVE
Mailing Address - Street 2:
Mailing Address - City:MILL VALLEY
Mailing Address - State:CA
Mailing Address - Zip Code:94941-5057
Mailing Address - Country:US
Mailing Address - Phone:415-309-3514
Mailing Address - Fax:
Practice Address - Street 1:159 MONTE VISTA AVE
Practice Address - Street 2:
Practice Address - City:MILL VALLEY
Practice Address - State:CA
Practice Address - Zip Code:94941-5057
Practice Address - Country:US
Practice Address - Phone:415-309-3514
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-01-07
Last Update Date:2025-01-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA10604171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes171100000XOther Service ProvidersAcupuncturistGroup - Single Specialty