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General NPI Number Information
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NPI Number | 1447939186
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Entity Type | Individual
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Provider Name | SARA NELSON
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Gender | Female
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Dates
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Enumeration Date | 07/11/2023
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Last Update Date | 07/11/2023
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Provider Practice Location Address
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Address Line | 24303 WALNUT ST STE 1
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City | NEWHALL
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State | CA
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Zip | 91321-2901
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Country | US
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Telephone | 661-410-6313
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Fax |
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Provider Business Mailing Address
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Address Line | 14019 AZTEC ST
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City | SYLMAR
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State | CA
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Zip | 91342-4102
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101YP2500X
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Taxonomy Name | Professional Counselor
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License Number | APCC10473
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License Number State | CA
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