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NPI Code Detail

MEDICARE: MS. SARA FAULKNER

MEDICARE: MS. SARA FAULKNER
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
1101YM0800XMental Health Counselor

General Provider Information

NPI Number : 1619136850
Entity Type Code : Individual
Provider Name (Legal Business Name) : MS. SARA FAULKNER
Provider Business Mailing Address
First Line : 3491 ELM AVE
Second Line :
City : LONG BEACH
State : CA
Zip : 90807-4430
Country : US
Telephone Number : 562-427-4864
Fax Number :
Provider Business Practice Location Address
First Line : 3491 ELM AVE
Second Line :
City : LONG BEACH
State : CA
Zip : 90807-4430
Country : US
Telephone Number : 562-427-4864
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/03/2008
Last Update Date : 06/03/2008

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