Provider Demographics
NPI:1619417748
Name:SABIN, KASANDRA RENEE (MFT INTERN)
Entity type:Individual
Prefix:
First Name:KASANDRA
Middle Name:RENEE
Last Name:SABIN
Suffix:
Gender:F
Credentials:MFT INTERN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5005 TEXAS ST STE 203
Mailing Address - Street 2:
Mailing Address - City:SAN DIEGO
Mailing Address - State:CA
Mailing Address - Zip Code:92108-3723
Mailing Address - Country:US
Mailing Address - Phone:619-692-0727
Mailing Address - Fax:
Practice Address - Street 1:3751 BANCROFT ST
Practice Address - Street 2:# 3
Practice Address - City:SAN DIEGO
Practice Address - State:CA
Practice Address - Zip Code:92104-3756
Practice Address - Country:US
Practice Address - Phone:253-732-1121
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-03-08
Last Update Date:2025-07-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CARBT-16-20999106S00000X
101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
No106S00000XBehavioral Health & Social Service ProvidersBehavior Technician