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General NPI Number Information
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NPI Number | 1730736026
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Entity Type | Individual
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Provider Name | SARA MICHELE PHILLIPS APCC 15753
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Gender | Female
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Dates
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Enumeration Date | 08/21/2019
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Last Update Date | 03/13/2025
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Provider Practice Location Address
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Address Line | 180 VIA VERDE STE 200
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City | SAN DIMAS
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State | CA
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Zip | 91773-3993
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Country | US
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Telephone | 909-599-1227
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Fax |
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Provider Business Mailing Address
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Address Line | 23361 MADERO STE 210
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City | MISSION VIEJO
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State | CA
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Zip | 92691-2715
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Country | US
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Telephone | 858-583-6188
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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 | APC15753
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License Number State | CA
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