MEDICARE: SARAH MILLWEE-WELCH PHD

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	103TC0700X	Clinical Psychologist	PSY33413	CA

General Provider Information

NPI Number	:	1487384418
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	SARAH MILLWEE-WELCH PHD

Provider Business Mailing Address
First Line	:	196 CALIFORNIA CT
Second Line	:
City	:	MISSION VIEJO
State	:	CA
Zip	:	92692-5302
Country	:	US
Telephone Number	:	949-616-9848
Fax Number	:

Provider Business Practice Location Address
First Line	:	16162 BEACH BLVD STE 308
Second Line	:
City	:	HUNTINGTON BEACH
State	:	CA
Zip	:	92647-3894
Country	:	US
Telephone Number	:	949-616-9848
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	06/13/2022
Last Update Date	:	07/13/2022

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