Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 102L00000X | Psychologist | 05632 | MD |
N | 103T00000X | Psychologist | 05632 | MD |
Y | 102L00000X | Psychologist | 28978 | CA |
Y | 103T00000X | Psychologist | 28978 | CA |
NPI | 1003323189 |
---|---|
Provider Name | Dr. Sarah Newton Gruszka |
First Address | Cardiff By The Sea, CA 92007-1003 |
Second Address | San Diego, CA 92103-2204 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 10/01/2018 |
Last Update Date | 10/01/2018 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
05632 | PSYCHOLOGY LICENSE (01) | MD |
28978 | PSYCHOLOGY LICENSE (01) | CA |