Healthcare Provider Details

I. General information

NPI: 1497027916
Provider Name (Legal Business Name): SARAH LYNNE KINGTON LCSW
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

Provider Other Name: SARAH LYNNE FREALY

II. Dates (important events)

Enumeration Date: 01/30/2012
Last Update Date: 10/08/2024
Certification Date: 10/08/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

23 CALOTTE PL
FOOTHILL RANCH CA
92610-2615
US

IV. Provider business mailing address

23 CALOTTE PL
FOOTHILL RANCH CA
92610-2615
US

V. Phone/Fax

Practice location:
  • Phone: 949-728-8616
  • Fax:
Mailing address:
  • Phone: 562-477-2837
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code104100000X
TaxonomySocial Worker
License NumberLCS 27842
License Number StateCA
# 2
Primary TaxonomyN
Taxonomy Code104100000X
TaxonomySocial Worker
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: