Healthcare Provider Details

I. General information

NPI: 1174901656
Provider Name (Legal Business Name): SARAH HERRICK
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/15/2015
Last Update Date: 08/11/2026
Certification Date: 08/11/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6321 HWY 116
FORESTVILLE CA
95436-9606
US

IV. Provider business mailing address

550 OASIS DR
SANTA ROSA CA
95407-7717
US

V. Phone/Fax

Practice location:
  • Phone: 707-828-0785
  • Fax:
Mailing address:
  • Phone: 707-485-2589
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code171400000X
TaxonomyHealth & Wellness Coach
License NumberBD97A81DE5
License Number StateCA
# 2
Primary TaxonomyY
Taxonomy Code103K00000X
TaxonomyBehavior Analyst
License Number11313993
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: