Healthcare Provider Details

I. General information

NPI: 1073773966
Provider Name (Legal Business Name): SARA LYNN WATTS LMFT
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/13/2008
Last Update Date: 08/05/2020
Certification Date: 08/05/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2231 SAINT GEORGE LN STE 10
CHICO CA
95926-1314
US

IV. Provider business mailing address

2231 SAINT GEORGE LN STE 10
CHICO CA
95926-1314
US

V. Phone/Fax

Practice location:
  • Phone: 831-233-4456
  • Fax:
Mailing address:
  • Phone: 831-233-4456
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code106H00000X
TaxonomyMarriage & Family Therapist
License Number50458
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: