Provider Demographics
NPI:1699280438
Name:POOLE, SARAH
Entity type:Individual
Prefix:
First Name:SARAH
Middle Name:
Last Name:POOLE
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 1:140 JONES ST
Mailing Address - Street 2:
Mailing Address - City:SAN FRANCISCO
Mailing Address - State:CA
Mailing Address - Zip Code:94102-3969
Mailing Address - Country:US
Mailing Address - Phone:415-776-2115
Mailing Address - Fax:415-776-3913
Practice Address - Street 1:1385 MISSION ST STE 200
Practice Address - Street 2:
Practice Address - City:SAN FRANCISCO
Practice Address - State:CA
Practice Address - Zip Code:94103-2631
Practice Address - Country:US
Practice Address - Phone:415-864-7833
Practice Address - Fax:415-864-2231
Is Sole Proprietor?:No
Enumeration Date:2017-12-01
Last Update Date:2020-03-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA101Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor