MEDICARE: SARAH HOLROYDE BORREGO LCSW25329

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	1041C0700X	Clinical Social Worker	25329	CA
2	1041C0700X	Clinical Social Worker	LCSW25329	CA

General Provider Information

NPI Number	:	1407079437
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	SARAH HOLROYDE BORREGO LCSW25329

Provider Business Mailing Address
First Line	:	3719 LIBERTY CANYON RD
Second Line	:
City	:	AGOURA HILLS
State	:	CA
Zip	:	91301-3504
Country	:	US
Telephone Number	:	626-513-5787
Fax Number	:

Provider Business Practice Location Address
First Line	:	2277 TOWNSGATE RD
Second Line	:	STE 102
City	:	WESTLAKE VILLAGE
State	:	CA
Zip	:	91361-2415
Country	:	US
Telephone Number	:	626-513-5787
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	04/10/2007
Last Update Date	:	06/24/2019

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