Healthcare Provider Details

I. General information

NPI: 1336085034
Provider Name (Legal Business Name): CHARLOTTE ANNA SARGENT MA, AMFT
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 04/25/2026
Last Update Date: 04/25/2026
Certification Date: 04/25/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4230 OVERLAND AVE
CULVER CITY CA
90230-3736
US

IV. Provider business mailing address

800 NEW DEPOT ST APT 1
LOS ANGELES CA
90012-1658
US

V. Phone/Fax

Practice location:
  • Phone: 201-463-8578
  • Fax:
Mailing address:
  • Phone: 201-463-8578
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code106H00000X
TaxonomyMarriage & Family Therapist
License Number143607
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: