Healthcare Provider Details

I. General information

NPI: 1215513502
Provider Name (Legal Business Name): SARAH ONTELL
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/18/2021
Last Update Date: 07/30/2024
Certification Date: 07/22/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

312 S JUNIPER ST STE 202
ESCONDIDO CA
92025-4998
US

IV. Provider business mailing address

1664 BROADWAY
EL CAJON CA
92021-5201
US

V. Phone/Fax

Practice location:
  • Phone: 888-428-3223
  • Fax: 323-866-1881
Mailing address:
  • Phone: 619-579-8685
  • Fax: 619-579-1969

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License NumberAMFT143395
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: