Basic Information
Provider Information
NPI: 1598174633
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: WATKINS
FirstName: SABRINA
MiddleName: JULIANNE
NamePrefix:  
NameSuffix:  
Credential: PMHNP, RN
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
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OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 1430 COLLIER ST
Address2:  
City: AUSTIN
State: TX
PostalCode: 787042911
CountryCode: US
TelephoneNumber: 5124724357
FaxNumber: 5127031394
Practice Location
Address1: 6222 N LAMAR BLVD
Address2:  
City: AUSTIN
State: TX
PostalCode: 787524004
CountryCode: US
TelephoneNumber: 5124724357
FaxNumber: 5127031390
Other Information
ProviderEnumerationDate: 08/02/2014
LastUpdateDate: 09/12/2019
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: F
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
363LP0808X0024177311VAN Physician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsych/Mental Health
363LP0808XAC002849MDN Physician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsych/Mental Health
363LP0808XAP126023TXY Physician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsych/Mental Health

No ID Information.


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