MEDICARE: SARA SIERRA-VALINSKY LCSW

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	19243	CA

General Provider Information

NPI Number	:	1497194443
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	SARA SIERRA-VALINSKY LCSW

Provider Business Mailing Address
First Line	:	9114 ADAMS AVE # 244
Second Line	:
City	:	HUNTINGTON BEACH
State	:	CA
Zip	:	92646-3405
Country	:	US
Telephone Number	:	714-594-9477
Fax Number	:

Provider Business Practice Location Address
First Line	:	10061 TALBERT AVE STE 200
Second Line	:
City	:	FOUNTAIN VALLEY
State	:	CA
Zip	:	92708-5123
Country	:	US
Telephone Number	:	714-594-9477
Fax Number	:

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

Provider Enumeration Date	:	06/21/2013
Last Update Date	:	06/21/2013

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