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General NPI Number Information
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NPI Number | 1619517562
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Entity Type | Individual
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Provider Name | SARA LEANN KOLSIN LCSW
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Gender | Female
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Dates
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Enumeration Date | 01/08/2020
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Last Update Date | 08/12/2021
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Provider Practice Location Address
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Address Line | 550 N GOLDEN CIRCLE DR STE A
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City | SANTA ANA
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State | CA
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Zip | 92705-3977
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Country | US
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Telephone | 714-287-4846
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 6124
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City | ANAHEIM
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State | CA
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Zip | 92816-0124
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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 | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number | 96560
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License Number State | CA
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