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General NPI Number Information
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NPI Number | 1790162139
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Entity Type | Organization
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Legal Business Name | SARAH KELLEY, M.S., LMFT
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Dates
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Enumeration Date | 05/06/2015
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Last Update Date | 05/06/2015
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Provider Practice Location Address
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Address Line | 2030 E 4TH ST STE. 158
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City | SANTA ANA
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State | CA
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Zip | 92705-3940
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Country | US
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Telephone | 714-271-3643
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Fax |
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Provider Business Mailing Address
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Address Line | 604 S PORTO PL
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City | ANAHEIM
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State | CA
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Zip | 92802-1438
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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 | MARRIAGE AND FAMILY THERAPIST
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Name | SARAH KELLEY
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Credential | M.S.
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Telephone | 714-271-3643
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251S00000X
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Taxonomy Name | Community/Behavioral Health Agency
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License Number | LMFT83792
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License Number State | CA
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