Basic Information
Provider Information
NPI: 1356975619
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: APOLINAR
FirstName: SABRINA
MiddleName: JACQUELINE
NamePrefix:  
NameSuffix:  
Credential:  
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 707 NIANTIC AVE
Address2:  
City: DALY CITY
State: CA
PostalCode: 940141913
CountryCode: US
TelephoneNumber: 2099477059
FaxNumber:  
Practice Location
Address1: 1801 VICENTE ST
Address2:  
City: SAN FRANCISCO
State: CA
PostalCode: 941162923
CountryCode: US
TelephoneNumber: 4156813211
FaxNumber:  
Other Information
ProviderEnumerationDate: 02/26/2020
LastUpdateDate: 03/31/2020
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: F
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate: 03/31/2020

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
172V00000X  Y Other Service ProvidersCommunity Health Worker 

No ID Information.


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