Healthcare Provider Details

I. General information

NPI: 1093722431
Provider Name (Legal Business Name): SARAH VIRGINIA ADAMS PSY.D. LMFT
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/01/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

260 S GLENDORA AVE STE 106-107
WEST COVINA CA
91790-3041
US

IV. Provider business mailing address

260 S GLENDORA AVE STE 106-107
WEST COVINA CA
91790-3041
US

V. Phone/Fax

Practice location:
  • Phone: 626-919-2584
  • Fax: 626-918-4610
Mailing address:
  • Phone: 626-919-2584
  • Fax: 626-918-4610

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103TF0000X
TaxonomyFamily Psychologist
License NumberMFC 20837
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: