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General NPI Number Information
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NPI Number | 1629615984
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Entity Type | Individual
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Provider Name | SARA AFSHARPOUR
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Gender | Female
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Dates
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Enumeration Date | 12/05/2019
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Last Update Date | 05/23/2023
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Provider Practice Location Address
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Address Line | 23331 EL TORO RD STE 208
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City | LAKE FOREST
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State | CA
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Zip | 92630-4883
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Country | US
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Telephone | 949-391-7790
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Fax |
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Provider Business Mailing Address
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Address Line | 6 IMPERATRICE
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City | DANA POINT
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State | CA
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Zip | 92629-4115
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Country | US
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Telephone | 949-291-6275
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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 | 106H00000X
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Taxonomy Name | Marriage & Family Therapist
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License Number | 139443
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License Number State | CA
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Taxonomy #2
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Taxonomy Code | 106H00000X
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Taxonomy Name | Marriage & Family Therapist
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License Number |
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License Number State |
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