Healthcare Provider Details

I. General information

NPI: 1326812066
Provider Name (Legal Business Name): SARAH MEEKS LEP
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 11/13/2023
Last Update Date: 09/16/2026
Certification Date: 09/16/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3420 BRISTOL ST
COSTA MESA CA
92626-7170
US

IV. Provider business mailing address

9114 ADAMS AVE # 604
HUNTINGTON BEACH CA
92646-3405
US

V. Phone/Fax

Practice location:
  • Phone: 949-478-4484
  • Fax:
Mailing address:
  • Phone: 949-424-7357
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103TS0200X
TaxonomySchool Psychologist
License Number4426
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: