Healthcare Provider Details

I. General information

NPI: 1073467486
Provider Name (Legal Business Name): SARA MARGARITA LIZARRAGA
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 02/23/2026
Last Update Date: 05/21/2026
Certification Date: 05/21/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

301 THE CITY DR S # FI2
ORANGE CA
92868-3205
US

IV. Provider business mailing address

2157 SPENCER AVE
POMONA CA
91767-2354
US

V. Phone/Fax

Practice location:
  • Phone: 714-935-6363
  • Fax:
Mailing address:
  • Phone: 323-547-5987
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code106H00000X
TaxonomyMarriage & Family Therapist
License NumberAMFT158221
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: