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NPI Code Detail

MEDICARE: MRS. SARA CLOOSTERMANS LMFT, LPCC

MEDICARE:  MRS. SARA  CLOOSTERMANS  LMFT, LPCC
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 CounselorLPCC39CA
2106H00000XMarriage & Family TherapistLMFT48669CA

General Provider Information

NPI Number : 1821212564
Entity Type Code : Individual
Provider Name (Legal Business Name) : MRS. SARA CLOOSTERMANS LMFT, LPCC
Provider Business Mailing Address
First Line : 3725 TALBOT ST STE F
Second Line :
City : SAN DIEGO
State : CA
Zip : 92106-2052
Country : US
Telephone Number : 619-847-5333
Fax Number :
Provider Business Practice Location Address
First Line : 3725 TALBOT ST STE F
Second Line :
City : SAN DIEGO
State : CA
Zip : 92106-2052
Country : US
Telephone Number : 619-847-5333
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 04/12/2007
Last Update Date : 05/04/2020

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