Healthcare Provider Details
I. General information
NPI: 1427437169
Provider Name (Legal Business Name): SADE OWNEY
Entity Type: Individual
Gender: Female
Sole Proprietor: N
II. Dates (important events)
Enumeration Date: 05/27/2015
Last Update Date: 08/14/2019
Certification Date:
Deactivation Date:
Reactivation Date:
III. Provider practice location address
801 E CHAPMAN AVE STE 203
FULLERTON CA
92831-3846
US
IV. Provider business mailing address
PO BOX 919
FULLERTON CA
92836-0919
US
V. Phone/Fax
- Phone: 714-680-9000
- Fax: 714-680-8233
- Phone: 714-680-9000
- Fax: 714-680-8233
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | N |
| Taxonomy Code | 171M00000X |
| Taxonomy | Case Manager/Care Coordinator |
| License Number | |
| License Number State | |
| # 2 | |
| Primary Taxonomy | N |
| Taxonomy Code | 390200000X |
| Taxonomy | Student in an Organized Health Care Education/Training Program |
| License Number | |
| License Number State | |
| # 3 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 101YM0800X |
| Taxonomy | Mental Health Counselor |
| License Number | 91056 |
| License Number State | CA |
VIII. Authorized Official
Name:
Title or Position:
Credential:
Phone: