Individual
TABATHA DAWN SEBASTIAN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
2085 RUSTIN AVE BLDG 3, RIVERSIDE, CA 92507-2498
(951) 358-4100
Mailing address
2085 RUSTIN AVE BLDG 3, RIVERSIDE, CA 92507-2498
(951) 358-4100
Taxonomy
Speciality
Code
Description
License number
State
175T00000X
Peer Specialist
Primary
—
CA
Other
Enumeration date
07/06/2017
Last updated
07/21/2022
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