MEDICARE: SARAH BREUNIG 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	124247	CA

General Provider Information

NPI Number	:	1942908405
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	SARAH BREUNIG LMFT

Provider Business Mailing Address
First Line	:	9826 PORTOLA DR
Second Line	:
City	:	BEVERLY HILLS
State	:	CA
Zip	:	90210-1421
Country	:	US
Telephone Number	:	424-853-2606
Fax Number	:

Provider Business Practice Location Address
First Line	:	9826 PORTOLA DR
Second Line	:
City	:	BEVERLY HILLS
State	:	CA
Zip	:	90210-1421
Country	:	US
Telephone Number	:	424-853-2606
Fax Number	:

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

Provider Enumeration Date	:	02/22/2023
Last Update Date	:	02/22/2023

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