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Organization
SARA PROVENCE LMFT
Active
Organization
SARA PROVENCE LMFT
Active
Organization subpart
No
Provider details
NPI number
Authorized official
SARA PROVENCE LMFT (LMFT (THERAPIST))
(619) 354-2249
Entity
Organization
Contact information
Practice address
3455 INGRAHAM ST, SAN DIEGO, CA 92109-6713
(619) 723-6004
Mailing address
9528 MIRAMAR RD, SAN DIEGO, CA 92126-4533
Taxonomy
Speciality
Code
Description
License number
State
106H00000X
Marriage & Family Therapist
Primary
—
NULL
106H00000X
Marriage & Family Therapist
Primary
—
—
261QM0850X
Adult Mental Health Clinic/Center
—
NULL
Other
Enumeration date
02/27/2023
Last updated
03/09/2023
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