Healthcare Provider Details

I. General information

NPI: 1518873421
Provider Name (Legal Business Name): SARA HENRY
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/20/2026
Last Update Date: 08/20/2026
Certification Date: 08/20/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5000 BIRCH ST STE 1400
NEWPORT BEACH CA
92660-2150
US

IV. Provider business mailing address

5000 BIRCH ST STE 1400
NEWPORT BEACH CA
92660-2150
US

V. Phone/Fax

Practice location:
  • Phone: 949-335-5545
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number156433
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: