Healthcare Provider Details

I. General information

NPI: 1912458175
Provider Name (Legal Business Name): SARAH BROWN LMFT
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/21/2016
Last Update Date: 07/20/2022
Certification Date: 07/20/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

19712 MACARTHUR BLVD STE 110
IRVINE CA
92612-2407
US

IV. Provider business mailing address

2646 DUPONT DR STE 60350
IRVINE CA
92612-8887
US

V. Phone/Fax

Practice location:
  • Phone: 714-701-7464
  • Fax:
Mailing address:
  • Phone: 714-701-6474
  • Fax: 562-921-5703

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code106H00000X
TaxonomyMarriage & Family Therapist
License Number119305
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: