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General NPI Number Information
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NPI Number | 1831584820
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Entity Type | Organization
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Legal Business Name | DR. SARA MANGAT PROFESSIONAL PSYCHOLOGICAL CORP.
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Dates
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Enumeration Date | 04/06/2015
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Last Update Date | 10/09/2015
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Provider Practice Location Address
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Address Line | 3625 E THOUSAND OAKS BLVD SUITE 109
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City | WESTLAKE VILLAGE
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State | CA
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Zip | 91362-3626
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Country | US
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Telephone | 310-991-5401
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Fax |
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Provider Business Mailing Address
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Address Line | 30101 AGOURA CT SUITE 100
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City | AGOURA
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State | CA
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Zip | 91301-4300
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Country | US
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Telephone | 310-991-5401
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Fax |
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. SARABJIT MANGAT
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Credential | PSY.D
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Telephone | 310-991-5401
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 103TC0700X
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Taxonomy Name | Clinical Psychologist
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License Number | PSY22651
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License Number State | CA
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