Healthcare Provider Details

I. General information

NPI: 1093820276
Provider Name (Legal Business Name): SARAH MERCHANT BREDING LCSW
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/20/2006
Last Update Date: 03/07/2017
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

125 W MISSION AVE SUITE 103
ESCONDIDO CA
92025-1720
US

IV. Provider business mailing address

1069 PASSIFLORA AVE
ENCINITAS CA
92024-2215
US

V. Phone/Fax

Practice location:
  • Phone: 760-747-3424
  • Fax: 760-747-3435
Mailing address:
  • Phone: 760-505-0588
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License NumberLCS15135
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: