MEDICARE: SARAH MARIE FIELDS LMFT

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	106H00000X	Marriage & Family Therapist	54059	CA

General Provider Information

NPI Number	:	1619131992
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	SARAH MARIE FIELDS LMFT

Provider Business Mailing Address
First Line	:	520 S EL CAMINO REAL
Second Line	:	SUITE 716
City	:	SAN MATEO
State	:	CA
Zip	:	94402-1726
Country	:	US
Telephone Number	:	408-768-1864
Fax Number	:

Provider Business Practice Location Address
First Line	:	520 S EL CAMINO REAL
Second Line	:	SUITE 716
City	:	SAN MATEO
State	:	CA
Zip	:	94402-1726
Country	:	US
Telephone Number	:	408-768-1864
Fax Number	:

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

Provider Enumeration Date	:	07/15/2008
Last Update Date	:	07/21/2014

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